Related Experiment Video
Updated: Jun 6, 2026
07:16
An Educational Video Demonstration of How to Prone a Critically Ill Intubated Patient
Published on: November 30, 2022
Do elderly patients fare well in the ICU?
Brian H Nathanson1, Thomas L Higgins2, Maura J Brennan2
1From OptiStatim, LLC, Longmeadow, MA.
Chest
|November 13, 2010
Summary
Advanced age alone is not a significant predictor of mortality in intensive care units (ICUs). Patient subgroup and comorbidities significantly influence survival rates, even in elderly patients.
Area of Science:
- Critical Care Medicine
- Geriatric Medicine
- Health Services Research
Background:
- A prior analysis of the Mortality Probability Model (MPM)-III indicated that 14% of intensive care unit (ICU) patients had age as their sole risk factor for hospital mortality.
- This specific subgroup exhibited a notably lower mortality rate (2%) compared to the overall ICU mortality rate (14%).
- Significant variations in mortality rates were observed among elderly patients based on their clinical profiles.
Purpose of the Study:
- To conduct an in-depth analysis of age-related mortality patterns in intensive care unit (ICU) patients.
- To investigate how patient stratification (surgical vs. medical) and the presence of additional risk factors modify the impact of age on mortality.
- To provide a nuanced understanding of mortality risk beyond chronological age in critical care settings.
Main Methods:
- Utilized data from Project IMPACT, encompassing 124,885 patients across 135 ICUs between 2001 and 2004.
- Stratified patients into elective surgical, emergency/unscheduled surgical, and medical categories.
- Further categorized patients by age groups and the presence or absence of additional MPM risk factors to assess mortality differentials.
Main Results:
- Mortality rates consistently increased with advancing age across all patient categories.
- Elective surgical patients without other risk factors demonstrated the lowest mortality (0.4% in 18-29 year olds to 9.2% in ≥90 year olds).
- Medical patients with additional risk factors exhibited the highest mortality (12.1% in 18-29 year olds to 36.0% in ≥90 year olds).
- Mortality in elective surgical patients aged 70s, 80s, and 90s approximately doubled (2.4% to 9.2%), while rising less dramatically in the medical group (27.0% to 36.0%).
Conclusions:
- While mortality increases with age, the specific patient subgroup significantly impacts risk, even among the elderly, suggesting potential selection bias.
- Advanced age itself should not be a barrier to ICU and surgical interventions.
- The presence of comorbidities substantially diminishes the likelihood of survival to discharge across all age groups.
Related Concept Videos
01:28Acute Coronary Syndrome IV: Interprofessional Care
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
01:19Restorative Care
Restorative care is provided once a patient has been discharged from a healthcare facility and requires additional services. The additional services include home care, rehabilitation programs, and extended care. Restorative care centers help the patient regain their previous level of functioning or acquire a new level of functioning due to the incapacitating effects of a disease or a disability. It aims to assist patients in enhancing their quality of life by encouraging independence,...
01:15Drug Dosing: Geriatric Patients
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
01:29Acute Respiratory Failure-V
The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Ensure that patients are monitored continuously for their response to therapy, including changes in...
01:29Endocarditis IV: Nursing Management
Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
01:28Pneumonia IV: Management
The treatment of pneumonia varies based on its severity and the causative pathogen. Here is a structured approach to managing pneumonia, integrating pharmaceutical and supportive care strategies.
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include: