PURPOSE: Multiple factors contribute to morbidity and mortality in acutely ill patients requiring intensive care monitoring. Factors ranging from the patient’s pre-hospitalization chronic conditions, acuity of presentation and progression of disease, many of which were categorized and incorporated into models that would help predict patient’s mortality like the APACHE score, MODS, and SAPS. Incorporated in all of these models is older age as an adverse prognostic factor. We compared the mortality of elderly and younger patients in the surgical ICU.
METHODS: We analyzed 4317 patients, admitted to our institution’s SICU. Patients under the age of 18, were excluded from the analysis. The APACHE I-III, MODS and SAPS scores were calculated upon admission to the SICU. Fisher’s test was used to compare the mortality between patients 75 years of age and older (N=1874) and patients younger than 75 (N=2443).
RESULTS: 30-day hospital mortality was 10.3%. The hospital mortality for elderly patients (>75 years old) was 11.7%, which was significantly higher than that for patients<75 years of age, 9.3% (P=0.0031). A statistically significant difference in mortality was appreciated between younger and older patient as early as 68 years of age (P=0.0499). There was no statistical difference between genders in either group. As there was also no significant difference in mortality between the two different age groups when the gender associated mortality was compared separately (Males; P=0.11, Females; P=0.07).
CONCLUSIONS: At our institution, elderly patients >75 years of age had a significantly higher mortality than younger patients, thereby confirming the adverse effect of older age on overall SICU outcome. A statistically significant difference in mortality was appreciated as early as 68 years of age.
CLINICAL IMPLICATIONS: Older age as early as 68 has an adverse effect on mortality in the surgical intensive care unit.
DISCLOSURE: The following authors have nothing to disclose: Adam Khader, Gary Deutsch, Denis Knobel, Garry Ritter, Corrado Marini, Rafael Barrera
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