Prognostic factors in emergency patients aged 90 years and older

We evaluated the relation between general status on arrival and prognosis in patients aged 90 years and older who were admitted to our department through the emergency room, with the aim of assisting the development of a treatment policy for elderly people.

We retrospectively analyzed patients aged 90 years and older who were admitted to our department from January 2006 to September 2013. Patients were divided into two groups, patients who were discharged from our hospital or transferred to another hospital, and patients who died in our hospital. Comparisons of the patients' general status and the results of blood examinations were carried out between the two groups. Independent parameters to predict prognosis were also evaluated.

Fifty-eight patients were enrolled in this study. The mean age was 93.2 ± 3.4 years (range, 90-106 years). Forty-five patients (77.6%) were discharged from our hospital (group A), and 13 patients (22.4%) died (group B). The percentage of patients with the inability to walk independently was significantly higher in group B. Mean arterial pressure, Glasgow Coma Scale (GCS), PaO₂/FiO₂ ratio, and serum albumin level on arrival were significantly better in group A. Multivariate logistic regression analysis indicated that the inability to walk independently (odds ratio, 22.4; 95% confidence interval, 4.4-113.1; P < 0.0001) and GCS (odds ratio, 7.0; 95% confidence interval, 1.8-27.7; P = 0.003) were the parameters to predict prognosis.

The inability to walk independently and GCS (consciousness status) are the most sensitive predictors of prognosis in emergency patients aged 90 years and older.