Influence of age and intensity of treatment on intra-ICU mortality of patients older than 65 years admitted to the intensive care unit

BackgroundAdvanced age might limit intensive care unit (ICU) admission or aggressive treatments. Outcome comparisons of elderly patients mortality admitted to the ICU have been made with a much younger population, admitted often times for different reasons and in significantly healthier conditions. This could lead to unreliable conclusions. This study assesses mortality in ICU patients age 65 and older who presumably have a closer health status, and the level of aggressiveness of ICU procedures performed on them.ObjectivesTo assess age-related intra-ICU mortality and ICU procedures performed in patients age 65 and older.Materials and methodsPatients admitted to a medical-surgical ICU were divided in two groups: group A, 65 to 74 years old and group B, older than 74. Both groups were compared for APACHE II score, admission group, length of stay, usual ICU procedures (arterial and venous catheters, mechanical ventilation and tracheostomy) and mortality.ResultsA total of 804 patients were included in group A (mean age 69.96 ± 2.8) and 605 in group B (mean age 78.81 ± 3.58). Mean APACHE II scores were 13.86 ± 8.6 for group A and 15.24 ± 8.96 for group B (P = 0.04). There were no differences for ICU procedures between age groups. Mortality was significantly higher in group B (16.5% vs 20.8%, P = 0.04). Mortality was higher only in the cardiac group (5.1% vs 9.7%, P = 0.005).ConclusionsIn this series of ICU patients, cardiac disorders had higher intra-ICU mortality in those older than 74 years old. Once admitted, no restriction for ICU procedures was applied to older patients.