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Clinical features and disease progression of elderly patients at the ICU setting

Raquel Rodríguez-García1, Loreto González-Lamuño2, Mario Santullano2

  • 1Servicio de Medicina Intensiva, Hospital Universitario Central de Asturias, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; CIBER-Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain.

Medicina Intensiva
|March 22, 2024
PubMed

Insights

This study characterizes octogenarian intensive care unit (ICU) patients, finding cardiac surgery associated with better outcomes than medical conditions like pneumonia. Age and frailty showed a significant positive association.

Area of Science:

  • Geriatric Medicine
  • Intensive Care Medicine
  • Clinical Epidemiology

Background:

  • Octogenarian patients represent a growing demographic in intensive care units (ICUs).
  • Understanding the characteristics and outcomes of this population is crucial for optimizing care.
  • Previous studies have not fully elucidated the specific factors influencing outcomes for octogenarians in the ICU.

Purpose of the Study:

  • To describe and characterize a cohort of octogenarian patients admitted to the intensive care unit (ICU).
  • To identify factors associated with outcomes, including mortality, in this patient group.

Main Methods:

  • A retrospective, observational, and descriptive study was conducted over 14 months.
  • Data were collected from patients over 80 years old admitted to the ICU for more than 24 hours.
  • Key variables included age, sex, comorbidities, functional dependence, treatment, complications, evolution, and mortality.

Main Results:

  • The most frequent admission reasons were cardiac surgery and pneumonia.
  • Patients under 85 had longer ICU stays. Invasive mechanical ventilation was more common in younger octogenarians (84.3%) versus older ones (46.2%).
  • Patients over 85 exhibited greater frailty. Cardiac surgery admission correlated with a lower mortality risk (HR=0.18; p=0.002).

Conclusions:

  • The reason for ICU admission significantly impacts mortality risk in octogenarian patients.
  • Cardiac surgery is linked to a better prognosis compared to medical conditions, with pneumonia indicating a higher mortality risk.
  • A significant positive association exists between advanced age and frailty in this cohort.
Abstract

Keywords:
AncianosEvoluciónEvolutionFrail elderlyIntensive care unitsMortalidadMortalityOutcomePronósticoUnidad de cuidados intensivos

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