Intensive care of the elderly--a retrospective study

Area of Science:

• Geriatric Medicine
• Critical Care Medicine
• Health Economics

Background:

• Intensive care is crucial for treating complex diseases in aging populations.
• Outcomes for elderly patients in intensive care units (ICUs) are not well-established.
• This study investigates the outcomes and cost-effectiveness of ICU care for older adults.

Purpose of the Study:

• To evaluate the outcomes of intensive care for patients aged 70 years and older.
• To compare mortality rates and length of stay in the ICU for elderly patients versus all age groups.
• To assess the cost-effectiveness of intensive care unit (ICU) interventions for elderly patients.

Main Methods:

• Follow-up study of 143 patients aged 70+ treated in the ICU for >= 48 hours (1979-1982).
• Comparison group: 143 patients of all ages treated in the ICU for >= 48 hours (1980).
• Analysis of diagnostic groups, mortality, length of stay, and ICU cost per patient-year saved.

Main Results:

• Mean 12-month mortality for patients aged 70+ was 52%, highest for cardiovascular (73%) and malignant (60%) diseases.
• 58% of ICU occupancy in the elderly group comprised patients who died within 18 months.
• ICU cost per patient-year saved was similar across diagnostic groups, regardless of mortality or stay duration.

Conclusions:

• While 50% of elderly patients returned home, indicating a positive humanitarian outcome, improved selection criteria for ICU admission are necessary.
• ICU cost-effectiveness calculations appear relevant for evaluating ICU care outcomes.
• Further research into patient selection criteria for intensive care is warranted to optimize resource allocation and patient outcomes.