Intensive care of the elderly--a retrospective study

Access to intensive care is to a large extent a prerequisite of the treatment of increasingly old patients for more and more complicated diseases. The ultimate outcome of such treatment is little known, however. In this study we have followed up 143 patients (91 males and 52 females), aged 70 years or more, who were treated in the intensive care unit (ICU) of Danderyd Hospital for 48 h or more during the years 1979-1982. As a comparison, another group of 143 patients in all age groups treated in the ICU for 48 h or more were studied during 1 year (1980). The main diagnostic groups were infectious diseases, trauma, acute abdominal diseases, malignancy, cardiovascular diseases, and other diseases. The mean mortality within 12 months at age 70 years and above was 52%, highest for cardiovascular diseases (73%) and malignant diseases (60%). Within this age group, the main part of the occupancy in our ICU was held by patients who died within 18 months (58%). The results show that the ICU-cost per patient per year saved was not much higher for patients in diagnostic groups with higher mortality or longer duration of stay in the ICU than in other groups. Calculations of ICU-cost seem to be a relevant parameter for the evaluation of the results of ICU care. Fifty per cent of all patients were able to return home some time after intensive care. The humanitarian end result is thus encouraging, but better criteria for selection of patients are needed.