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Critically ill elderly patients in a developing world--mortality and functional outcome at 1 year: a prospective

Swagata Tripathy1, J C Mishra2, S C Dash3

  • 1Department of Trauma and Emergency Medicine, All India Institute of Medical Sciences, Bhubaneswar, India.

Journal of Critical Care
|March 4, 2014
PubMed

Insights

Critically ill elderly patients face high mortality, with severe malnutrition and delirium being key risk factors. Survivors often achieve good functional status, highlighting the need for targeted interventions.

Area of Science:

  • Critical Care Medicine
  • Geriatric Medicine
  • Public Health

Background:

  • Elderly patients in intensive care units (ICUs) represent a growing demographic with complex health needs.
  • Understanding mortality and functional outcomes in this population is crucial, especially in developing countries.
  • Nutritional status and socioeconomic factors may significantly influence outcomes in critically ill older adults.

Purpose of the Study:

  • To investigate the mortality and long-term outcomes of critically ill elderly patients in a developing country.
  • To identify the impact of nutritional status and socioeconomic factors on mortality and functional outcomes.
  • To analyze risk factors associated with both short-term and long-term mortality in this patient group.

Main Methods:

  • A prospective study involving 109 elderly patients admitted to the ICU between 2011 and 2012.
  • Data collected included demographics, Acute Physiology and Chronic Health Evaluation (APACHE) II scores, malnutrition screening, socioeconomic status, and functional status.
  • One-year telephonic follow-up was conducted to assess patient outcomes, with statistical analyses including multivariate analysis and Kaplan-Meier survival analysis.

Main Results:

  • At 12 months post-discharge, the mortality rate was 46.8%.
  • Significant risk factors for 12-month mortality included higher APACHE II scores, severe malnutrition, and delirium.
  • While malnutrition and delirium were associated with mortality, socioeconomic status was not a significant factor. Most survivors (72%) had favorable functional status.

Conclusions:

  • Severe malnutrition, delirium, and elevated APACHE II scores are significant predictors of long-term mortality in critically ill elderly patients.
  • Survivors of critical illness in this population tend to experience good functional outcomes.
  • Development of appropriate quality of life assessment tools for this specific demographic is warranted.
Abstract

Keywords:
Developing worldFunctional outcomeGeriatric critical careMalnutrition screening in ICUQuality of lifeSocioeconomic classification (SEC)

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