Age, invasive ventilatory support and outcomes in elderly patients admitted to intensive care units

Background: although advancing age is associated with worse outcomes on mechanically ventilated elderly patients admitted to intensive care units (ICU), this relation has not been extensively investigated on patients not requiring invasive ventilatory support. Objective: to determine the relationshi...

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Bibliographic Details
Published in:Age and ageing 2009-09, Vol.38 (5), p.515-520
Main Authors: Farfel, Jose Marcelo, Franca, Suelene Aires, Sitta, Maria do Carmo, Filho, Wilson Jacob, Carvalho, Carlos Roberto Ribeiro
Format: Article
Language:English
Subjects:
Acute Disease - mortality
age
Age differences
Age Distribution
Aged
Aged patients
Aging
Artificial respiration
Care and treatment
Cohort analysis
elderly
Elderly patients
Female
Hospital Mortality
Humans
Intensive care
intensive care unit
Intensive care units
Intensive Care Units - statistics & numerical data
Invasive
invasive ventilatory support
Logistic Models
Male
Mechanical ventilation
Middle Aged
Mortality
Multivariate Analysis
Older people
Patient outcomes
Prognosis
Prospective Studies
Respiration, Artificial - mortality
Respiratory therapy
Sick elderly people
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Summary:Background: although advancing age is associated with worse outcomes on mechanically ventilated elderly patients admitted to intensive care units (ICU), this relation has not been extensively investigated on patients not requiring invasive ventilatory support. Objective: to determine the relationship between age and in-hospital mortality of elderly patients, admitted to ICU, requiring and not requiring invasive ventilatory support. Design: prospective observational cohort study conducted over a period of 11 months. Setting: medical-surgical ICU at a Brazilian university hospital. Subjects: a total of 840 patients aged 55 years and older were admitted to ICU. Methods: in-hospital death rates for patients requiring and not requiring invasive ventilatory support were compared across three successive age intervals (55–64; 65–74 and 75 or more years), adjusting for severity of illness using the Acute Physiologic Score. Results: age was strongly correlated with mortality among the invasively ventilated subgroup of patients and the multivariate adjusted odds ratios increased progressively with every age increment (OR = 1.60, 95% CI = 1.01–2.54 for 65–74 years old and OR = 2.68, 95% CI = 1.58–4.56 for ≥75 years). For the patients not submitted to invasive ventilatory support, age was not independently associated with in-hospital mortality (OR = 2.28, 95% CI = 0.99–5.25 for 65–74 years old and OR = 1.95, 95% CI = 0.82–4.62 for ≥75 years old). Conclusions: the combination of age and invasive mechanical ventilation is strongly associated with in-hospital mortality. Age should not be considered as a factor related to in-hospital mortality of elderly patients not requiring invasive ventilatory support in ICU.
ISSN:0002-0729
1468-2834
DOI:10.1093/ageing/afp119