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Mortality in elderly ICU patients: a cohort study
Author(s) -
NIELSSON M. S.,
CHRISTIANSEN C. F.,
JOHANSEN M. B.,
RASMUSSEN B. S.,
TØNNESEN E.,
NØRGAARD M.
Publication year - 2014
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.12211
Subject(s) - medicine , confidence interval , intensive care unit , cohort , mortality rate , elective surgery , cohort study , danish , pediatrics , emergency medicine , surgery , philosophy , linguistics
Background The population is aging. We examined changes in the proportion of elderly (≥ 80 years) intensive care unit ( ICU ) patients during 2005–2011 and the association between age and mortality controlling for preexisting morbidity. Methods Through the D anish N ational P atient R egistry, we identified a cohort of 49,938 ICU admissions (47,596 patients) in N orthern D enmark from 2005 to 2011. Patients were subdivided in age groups (15–49, 50–64, 65–79 and ≥ 80 years) and calendar year. We estimated 30‐day and 31–365‐day mortality and mortality rate ratios ( MRRs ), stratified by admission type (medical and elective/acute surgical patients). Mortality was compared between age groups adjusting for sex and preexisting morbidity using 50–64‐year‐olds as reference. Results The proportion of elderly patients increased from 11.7% of all ICU patients in 2005 to 13.8% in 2011. Among the elderly, the 30‐day mortality was 43.7% in medical, 39.6% in acute surgical, and 11.6% in elective surgical ICU patients. The corresponding adjusted 30‐day MRRs compared with the 50–64‐year‐olds were 2.7 [95% confidence interval ( CI ) 2.5–3.0] in medical, 2.7 (95% CI 2.4–3.0) in acute surgical, and 5.2 (95% CI 4.1–6.6) in elective surgical ICU patients. The 31–365‐day mortality among elderly patients was 25.4% in medical, 26.9% in acute, and 11.9% in elective surgical ICU patients, corresponding to adjusted MRRs of 2.5 (95% CI 2.1–2.9), 2.2 (95% CI 1.9–2.5), and 1.9 (95% CI 1.6–2.3), respectively. Conclusions During 2005–2011, there was an 18% increase in the proportion of elderly ICU patients. Advancing age is associated with increased mortality even after controlling for preexisting morbidity.