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Mortality in elderly ICU patients: a cohort study

2013; Wiley; Volume: 58; Issue: 1 Linguagem: Inglês

10.1111/aas.12211

1399-6576

Malene Schou Nielsson, Christian Fynbo Christiansen, Martin Berg Johansen, Bodil Steen Rasmussen, Else Tønnesen, Mette Nørgaard,

Sepsis Diagnosis and Treatment

Background The population is aging. We examined changes in the proportion of elderly (≥ 80 years) intensive care unit (ICU) patients during 2005–2011 and the association between age and mortality controlling for preexisting morbidity. Methods Through the Danish National Patient Registry, we identified a cohort of 49,938 ICU admissions (47,596 patients) in Northern Denmark from 2005 to 2011. Patients were subdivided in age groups (15–49, 50–64, 65–79 and ≥ 80 years) and calendar year. We estimated 30-day and 31–365-day mortality and mortality rate ratios (MRRs), stratified by admission type (medical and elective/acute surgical patients). Mortality was compared between age groups adjusting for sex and preexisting morbidity using 50–64-year-olds as reference. Results The proportion of elderly patients increased from 11.7% of all ICU patients in 2005 to 13.8% in 2011. Among the elderly, the 30-day mortality was 43.7% in medical, 39.6% in acute surgical, and 11.6% in elective surgical ICU patients. The corresponding adjusted 30-day MRRs compared with the 50–64-year-olds were 2.7 [95% confidence interval (CI) 2.5–3.0] in medical, 2.7 (95% CI 2.4–3.0) in acute surgical, and 5.2 (95% CI 4.1–6.6) in elective surgical ICU patients. The 31–365-day mortality among elderly patients was 25.4% in medical, 26.9% in acute, and 11.9% in elective surgical ICU patients, corresponding to adjusted MRRs of 2.5 (95% CI 2.1–2.9), 2.2 (95% CI 1.9–2.5), and 1.9 (95% CI 1.6–2.3), respectively. Conclusions During 2005–2011, there was an 18% increase in the proportion of elderly ICU patients. Advancing age is associated with increased mortality even after controlling for preexisting morbidity.