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Intensive care unit use and mortality in the elderly
1Health Care Research Unit, Section of General Internal Medicine, Evans Department of Medicine, Boston Medical Center, Boston, Mass; Boston University School of Medicine, Boston, MA 02118, USA.
Journal of General Internal Medicine
|February 15, 2000
Summary
Intensive care unit (ICU) use for elderly Medicare beneficiaries decreased with age. Most elderly patients, including the oldest and those with expensive ICU care, survived at least 90 days.
Area of Science:
- Geriatric Medicine
- Health Services Research
- Critical Care Medicine
Background:
- Elderly populations are growing, necessitating research into their healthcare utilization.
- Understanding intensive care unit (ICU) use among older adults is crucial for resource allocation and outcome assessment.
Purpose of the Study:
- To investigate the patterns of ICU utilization among elderly individuals in the United States.
- To analyze the survival outcomes associated with ICU care in different age groups within the elderly Medicare population.
Main Methods:
- Utilized 1992 Health Care Financing Administration data for elderly Medicare beneficiaries.
- Examined ICU utilization and mortality rates stratified by age and reason for hospital admission.
Main Results:
- ICU utilization was lowest for the oldest elderly (85+ years) at 21.1%, increasing with younger age groups (75-84 years: 27.9%; 65-74 years: 29.7%).
- Surgical admissions were associated with higher ICU use across all elderly age groups.
- Overall survival at 90 days post-ICU admission was 83%, with 74% survival for those 85+ years.
Conclusions:
- ICU utilization among the elderly declines with increasing age, particularly for those 85 years and older.
- The diagnostic mix significantly influences age-based ICU admission patterns.
- A substantial majority of elderly patients, including the oldest and those receiving high-cost ICU care, achieved 90-day survival.