Mortality in Critically Ill Elderly Individuals Receiving Mechanical Ventilation

Area of Science:

• Critical Care Medicine
• Geriatric Medicine
• Epidemiology

Background:

• Conflicting results exist regarding mortality in elderly patients requiring mechanical ventilation.
• Previous studies have not definitively established the impact of age on mortality in this population.

Purpose of the Study:

• To systematically review and evaluate the effect of age on mortality in elderly patients receiving mechanical ventilation.
• To assess secondary outcomes including severity scores, length of stay, and ventilator-associated pneumonia.

Main Methods:

• Systematic review of medical literature databases and references (1974-May 2015).
• Inclusion of studies comparing different age groups, with primary outcome of mortality in subjects aged ≥65 years.
• Subgroup analysis for subjects with ARDS and age cutoffs of 70 and 80 years; evidence quality assessed using GRADE criteria.

Main Results:

• 21 studies included, showing higher mortality in subjects aged ≥65 years (OR 1.80).
• Older subjects with ARDS and those aged 70 or 80 years also exhibited higher mortality rates.
• No significant differences were found in ICU/hospital length of stay or ventilator-associated pneumonia rates between age groups.

Conclusions:

• Age is associated with increased mortality in critically ill patients requiring mechanical ventilation.
• Despite low-quality evidence, the findings suggest a significant impact of age on survival outcomes.
• Further high-quality research is warranted to confirm these findings.