PURPOSE: To examine the outcome of elderly patients (> 80 yrs old) treated in a medical intensive care unit (ICU).
METHODS: Design: Retrospective cohort study. Setting: An eleven-bed medical ICU in a tertiary care, university hospital. Patients: A cohort of 84 patients, divided into two groups based on age who were admitted to the Medical ICU from April 2010 to September 2010.
RESULTS: We looked at 84 patients, admitted to the Medical ICU at a tertiary care center over a period of 6 months and followed them through discharge from the hospital. The patients were divided into two groups based on their age. 53 patients were < 80 years (mean: 53.3±15.1 yrs; 39 male, 14 female) while 31 patients were > 80 years (mean: 85.7±6.1 yrs; 18 male, 13 female). We calculated their APACHE II scores and the mean score was 16.19 in the group < 80 years and 21.06 in the group > 80years (p=0.003). We also recalculated their APACHE II scores after removing the points assigned to their age, following which their scores were 13.62 and 15.06 respectively (p=0.353). 64 patients (42 in the group < 80 years and 22 in the group > 80years; p=0.433) were discharged from the hospital either to a rehabilitation center, nursing home or their home. 20 patients died during the course of their hospitalization (11 in the group < 80 years and 9 in the group > 80years), either in the ICU or after they were transferred out of the ICU to a medical floor.
CONCLUSIONS: Aggressive medical care of the elderly is an issue under vigorous discussion. Care in ICUs accounts for a large part of the health care budget. There has been some suggestion that the threshold for admission to an ICU for elderly patients is lower and that that might lead to better outcomes as these patients are not as sick as younger patients who get admitted to ICU. However, our study shows that the majority of elderly patients are likely to survive an ICU stay and will eventually leave the hospital and that there is no difference in the severity of their illness based on their APACHE II scores.
CLINICAL IMPLICATIONS: Our data seems to suggest that age may not have a major impact on outcome from critical illness and therefore potentially justifies aggressive treatment of elderly patients.
DISCLOSURE: The following authors have nothing to disclose: Vishal Sekhri, Nimeshkumar Mehta, Nikhil Agrawal, Dipak Chandy
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