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Development of demographics and outcome of very old critically ill patients admitted to intensive care units

Gerald C. Ihra, Judith Lehberger, Helene Hochrieser, Peter Bauer, Rene Schmutz, Barbara Metnitz, Philipp G. H. Metnitz
Original
Volume 38, Issue 4 / April , 2012

Pages 620 - 626

Abstract

Purpose

To evaluate the development of demographics and outcome of very old (>80 years) critically ill patients admitted to intensive care units.

Setting

All consecutive patients admitted to 41 Austrian intensive care units (ICUs) over an 11-year period.

Methods

We performed a retrospective cohort study of prospectively collected data. To compare parameters over time, patients were divided into three groups (group I from 1998 until 2001, group II from 2002 to 2004, and group III from 2005 to 2008).

Results

A total of 17,126 patients older than 80 years of age were admitted over the study period. The proportion of very old patients increased from 11.5% (I) to 15.3% (III) with a significant higher prevalence of females in all groups (on average 63.2%). Severity of illness also increased over time, even when corrected for age. Use of noninvasive mechanical ventilation increased over the years. However, risk-adjusted mortality rates [observed-to-expected (O/E) ratios] decreased from 1.14 [confidence interval (CI) 1.11–1.18] to 1.02 (CI 0.99–1.05). This improvement in outcome was confirmed on multivariate analysis: for every year delay in ICU admission, the odds to die decreased by 3%. Moreover, females exhibited a better outcome compared with males.

Conclusions

The relative and absolute numbers of very old patients increased over the study period, as did the severity of illness. Despite this, risk-adjusted hospital mortality improved over the study period. Females dominated in the very old patients and exhibited moreover a better outcome compared with males.

Keywords

References

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