Characteristics, management and outcomes of critically ill patients who are 80 years and older: a retrospective comparative cohort study

Hasan M. Al-Dorzi, Hani M. Tamim, Shihab Mundekkadan, Muhammad R. Sohail, Yaseen M. Arabi

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

BACKGROUND: Older age is associated with chronic illnesses and disability, which contribute to increased admission to the intensive care unit (ICU). Our primary objective was to compare the characteristics, ICU management and outcomes of critically ill patients ≥ 80 year-old with those of younger patients.

METHODS: This was a retrospective cohort study of patients admitted to a tertiary-care ICU from 1999 to 2011. The characteristics, ICU management and outcomes of patients ≥ 80 year-old were compared with those 50-64.9 and 65-79.9 year-old. Multivariate analysis was performed to determine the adjusted risk of Do-Not-Resuscitate orders and hospital mortality in patients ≥ 80 year-old compared with the younger groups.

RESULTS: During the study period, patients aged ≥ 80 years (N = 748) represented 7.9% of all ICU admissions and 12.8% of patients aged ≥ 50 years. Chronic cardiac (32.2%) and respiratory (21.8%) diseases were more prevalent in them than the younger groups (p <0.0001). The most common reasons for their ICU admission were cardiovascular (30.9%) and respiratory (40.4%) conditions. Sepsis was commonly present in them on admission (32.9%). Mechanical ventilation and renal replacement therapy were commonly provided (76.9% and 16.0%, respectively). During ICU stay, Do-Not-Resuscitate orders were more frequently written for patients aged ≥ 80 years (35.0%) compared with 21.9% for 50-64.9 year-old group, p <0.0001, and 25.4% for the 60-79.9 year-old group, p <0.0001. On multivariate analysis, patients aged ≥ 80 years were more likely to receive these order compared with the 50-64.9 year-old patients (adjusted OR, 1.83; 95% CI, 1.45-2.31) and the 65-80 year-old patients (adjusted OR, 1.64; 95% CI, 1.32-2.04). The hospital mortality increased gradually with age and was highest (54.6%) in patients ≥ 80 year-old (p <0.0001). Patients ≥ 80 year-old had higher risk of hospital mortality compared with patients aged 50-64.9 years (adjusted OR, 2.16; 95% CI, 1.73-2.69) and with those aged 65-79.9 years (adjusted OR, 1.51; 95% CI, 1.23-1.86).

CONCLUSIONS: Patients ≥ 80 year-old represented a significant proportion of ICU admissions. Although they received life sustaining measures similar to younger groups, they had higher adjusted mortality risk compared with the younger groups.

Original languageEnglish (US)
Pages (from-to)126
Number of pages1
JournalBMC Anesthesiology
Volume14
DOIs
StatePublished - 2014
Externally publishedYes

Fingerprint

Critical Illness
Cohort Studies
Intensive Care Units
Hospital Mortality
Resuscitation Orders
Multivariate Analysis
Renal Replacement Therapy
Patient Admission
Tertiary Healthcare
Artificial Respiration
Sepsis
Chronic Disease
Retrospective Studies

Keywords

  • Aged 80 and over
  • Critical illness
  • Health outcome
  • Mortality

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Characteristics, management and outcomes of critically ill patients who are 80 years and older : a retrospective comparative cohort study. / Al-Dorzi, Hasan M.; Tamim, Hani M.; Mundekkadan, Shihab; Sohail, Muhammad R.; Arabi, Yaseen M.

In: BMC Anesthesiology, Vol. 14, 2014, p. 126.

Research output: Contribution to journalArticle

Al-Dorzi, Hasan M. ; Tamim, Hani M. ; Mundekkadan, Shihab ; Sohail, Muhammad R. ; Arabi, Yaseen M. / Characteristics, management and outcomes of critically ill patients who are 80 years and older : a retrospective comparative cohort study. In: BMC Anesthesiology. 2014 ; Vol. 14. pp. 126.
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abstract = "BACKGROUND: Older age is associated with chronic illnesses and disability, which contribute to increased admission to the intensive care unit (ICU). Our primary objective was to compare the characteristics, ICU management and outcomes of critically ill patients ≥ 80 year-old with those of younger patients.METHODS: This was a retrospective cohort study of patients admitted to a tertiary-care ICU from 1999 to 2011. The characteristics, ICU management and outcomes of patients ≥ 80 year-old were compared with those 50-64.9 and 65-79.9 year-old. Multivariate analysis was performed to determine the adjusted risk of Do-Not-Resuscitate orders and hospital mortality in patients ≥ 80 year-old compared with the younger groups.RESULTS: During the study period, patients aged ≥ 80 years (N = 748) represented 7.9{\%} of all ICU admissions and 12.8{\%} of patients aged ≥ 50 years. Chronic cardiac (32.2{\%}) and respiratory (21.8{\%}) diseases were more prevalent in them than the younger groups (p <0.0001). The most common reasons for their ICU admission were cardiovascular (30.9{\%}) and respiratory (40.4{\%}) conditions. Sepsis was commonly present in them on admission (32.9{\%}). Mechanical ventilation and renal replacement therapy were commonly provided (76.9{\%} and 16.0{\%}, respectively). During ICU stay, Do-Not-Resuscitate orders were more frequently written for patients aged ≥ 80 years (35.0{\%}) compared with 21.9{\%} for 50-64.9 year-old group, p <0.0001, and 25.4{\%} for the 60-79.9 year-old group, p <0.0001. On multivariate analysis, patients aged ≥ 80 years were more likely to receive these order compared with the 50-64.9 year-old patients (adjusted OR, 1.83; 95{\%} CI, 1.45-2.31) and the 65-80 year-old patients (adjusted OR, 1.64; 95{\%} CI, 1.32-2.04). The hospital mortality increased gradually with age and was highest (54.6{\%}) in patients ≥ 80 year-old (p <0.0001). Patients ≥ 80 year-old had higher risk of hospital mortality compared with patients aged 50-64.9 years (adjusted OR, 2.16; 95{\%} CI, 1.73-2.69) and with those aged 65-79.9 years (adjusted OR, 1.51; 95{\%} CI, 1.23-1.86).CONCLUSIONS: Patients ≥ 80 year-old represented a significant proportion of ICU admissions. Although they received life sustaining measures similar to younger groups, they had higher adjusted mortality risk compared with the younger groups.",
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T1 - Characteristics, management and outcomes of critically ill patients who are 80 years and older

T2 - a retrospective comparative cohort study

AU - Al-Dorzi, Hasan M.

AU - Tamim, Hani M.

AU - Mundekkadan, Shihab

AU - Sohail, Muhammad R.

AU - Arabi, Yaseen M.

PY - 2014

Y1 - 2014

N2 - BACKGROUND: Older age is associated with chronic illnesses and disability, which contribute to increased admission to the intensive care unit (ICU). Our primary objective was to compare the characteristics, ICU management and outcomes of critically ill patients ≥ 80 year-old with those of younger patients.METHODS: This was a retrospective cohort study of patients admitted to a tertiary-care ICU from 1999 to 2011. The characteristics, ICU management and outcomes of patients ≥ 80 year-old were compared with those 50-64.9 and 65-79.9 year-old. Multivariate analysis was performed to determine the adjusted risk of Do-Not-Resuscitate orders and hospital mortality in patients ≥ 80 year-old compared with the younger groups.RESULTS: During the study period, patients aged ≥ 80 years (N = 748) represented 7.9% of all ICU admissions and 12.8% of patients aged ≥ 50 years. Chronic cardiac (32.2%) and respiratory (21.8%) diseases were more prevalent in them than the younger groups (p <0.0001). The most common reasons for their ICU admission were cardiovascular (30.9%) and respiratory (40.4%) conditions. Sepsis was commonly present in them on admission (32.9%). Mechanical ventilation and renal replacement therapy were commonly provided (76.9% and 16.0%, respectively). During ICU stay, Do-Not-Resuscitate orders were more frequently written for patients aged ≥ 80 years (35.0%) compared with 21.9% for 50-64.9 year-old group, p <0.0001, and 25.4% for the 60-79.9 year-old group, p <0.0001. On multivariate analysis, patients aged ≥ 80 years were more likely to receive these order compared with the 50-64.9 year-old patients (adjusted OR, 1.83; 95% CI, 1.45-2.31) and the 65-80 year-old patients (adjusted OR, 1.64; 95% CI, 1.32-2.04). The hospital mortality increased gradually with age and was highest (54.6%) in patients ≥ 80 year-old (p <0.0001). Patients ≥ 80 year-old had higher risk of hospital mortality compared with patients aged 50-64.9 years (adjusted OR, 2.16; 95% CI, 1.73-2.69) and with those aged 65-79.9 years (adjusted OR, 1.51; 95% CI, 1.23-1.86).CONCLUSIONS: Patients ≥ 80 year-old represented a significant proportion of ICU admissions. Although they received life sustaining measures similar to younger groups, they had higher adjusted mortality risk compared with the younger groups.

AB - BACKGROUND: Older age is associated with chronic illnesses and disability, which contribute to increased admission to the intensive care unit (ICU). Our primary objective was to compare the characteristics, ICU management and outcomes of critically ill patients ≥ 80 year-old with those of younger patients.METHODS: This was a retrospective cohort study of patients admitted to a tertiary-care ICU from 1999 to 2011. The characteristics, ICU management and outcomes of patients ≥ 80 year-old were compared with those 50-64.9 and 65-79.9 year-old. Multivariate analysis was performed to determine the adjusted risk of Do-Not-Resuscitate orders and hospital mortality in patients ≥ 80 year-old compared with the younger groups.RESULTS: During the study period, patients aged ≥ 80 years (N = 748) represented 7.9% of all ICU admissions and 12.8% of patients aged ≥ 50 years. Chronic cardiac (32.2%) and respiratory (21.8%) diseases were more prevalent in them than the younger groups (p <0.0001). The most common reasons for their ICU admission were cardiovascular (30.9%) and respiratory (40.4%) conditions. Sepsis was commonly present in them on admission (32.9%). Mechanical ventilation and renal replacement therapy were commonly provided (76.9% and 16.0%, respectively). During ICU stay, Do-Not-Resuscitate orders were more frequently written for patients aged ≥ 80 years (35.0%) compared with 21.9% for 50-64.9 year-old group, p <0.0001, and 25.4% for the 60-79.9 year-old group, p <0.0001. On multivariate analysis, patients aged ≥ 80 years were more likely to receive these order compared with the 50-64.9 year-old patients (adjusted OR, 1.83; 95% CI, 1.45-2.31) and the 65-80 year-old patients (adjusted OR, 1.64; 95% CI, 1.32-2.04). The hospital mortality increased gradually with age and was highest (54.6%) in patients ≥ 80 year-old (p <0.0001). Patients ≥ 80 year-old had higher risk of hospital mortality compared with patients aged 50-64.9 years (adjusted OR, 2.16; 95% CI, 1.73-2.69) and with those aged 65-79.9 years (adjusted OR, 1.51; 95% CI, 1.23-1.86).CONCLUSIONS: Patients ≥ 80 year-old represented a significant proportion of ICU admissions. Although they received life sustaining measures similar to younger groups, they had higher adjusted mortality risk compared with the younger groups.

KW - Aged 80 and over

KW - Critical illness

KW - Health outcome

KW - Mortality

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