Cardiovascular profile in critically ill elderly medical patients: Prevalence, mortality and length of stay

• Prevalence of cardiovascular profile components in the elderly admitted to the ICU was high.
• Primary diagnosis for cardiovascular disease at ICU admission increased ICU mortality.
• Dyslipidemia, stroke and chronic kidney failure increased 1-year mortality.
• Antihypertensive treatment decreased 1-year mortality.
• Cardiovascular profile did not influence in-hospital mortality and length of stay.

PurposeData are demonstrating the increase in utilization of critical care by the elderly. Around 11% of ICU patients are ≥ 80 years-old.MethodsAn observational retrospective study was conducted between 2003 and 2011, including elderly patients (≥ 80 years old) admitted from medical services to the intensive care unit (ICU) in a tertiary university hospital. The final sample size was N = 202.ResultsMortality rates were: ICU 34.1%, in-hospital 44% and 1-year cumulative mortality 55.4% (20.4% for hospital survivors). Multivariate analysis showed that APACHE II score: OR 1.10, 95% CI (1.03–1.18), SAPS II score: OR 1.03, 95% CI (1.01–1.06), a score < 3 on the Cruz Roja Hospital mental scale: 0.51 OR, 95% CI (0.01–0.57) and ICU admission for cardiovascular disease: OR 5.05, 95% CI (1.98–12.84) were independently associated with mortality ICU. Factors independently associated with 1-year mortality were: dyslipidemia OR 7.25 (1.47–35.60), chronic kidney failure OR 13.23, 95% CI (2.28–76.6), stroke OR 10.44, 95% CI (2.26–48.25) and antihypertensive treatment OR 0.08, 95% CI (0.01–0.48). In multiple linear regression, ICU length of stay was associated with mechanical ventilation B coefficient 6.41, 95% CI (1.18–11.64) and in-hospital length of stay was related to age: B coefficient − 2.17, 95% CI (− 4.02 to − 0.33).ConclusionsPrevalence of cardiovascular risk factors and cardiovascular disease was high, and basal cardiovascular treatment was underused. Primary diagnosis for cardiovascular disease at ICU admission should be assessed as predictor of ICU mortality. Intensifying cardiovascular basal treatment could decrease 1-year mortality. Cardiovascular profile did not show an effect on in-hospital mortality and length of stay.