Seher Kır1, Buğra Kaan Bahçeci2, Eyüp Ayrancı2, Murat Balkoca2, Özkul Yılmaz Çolak2, Esma Ayrancı2, Melda Dilek3. 1. Department of Internal Medicine, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey. seherkr@yahoo.com. 2. Department of Internal Medicine, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey. 3. Department of Internal Medicine, Nephrology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey.
Abstract
BACKGROUND: The individuals over 65 years old constitute an important patient population of medical intensive care units (ICUs). AIM: To evaluate the risk factors for mortality in a medical ICU consisting a group of patients with a large number of co-morbidities. METHODS: This is a retrospective study involving patients who were followed for more than 48 h. The cohort was divided into two groups according to age: (1) young, < 65 years old, and (2) elderly, ≥ 65 years old. RESULTS: A total of 693 patients (303 F, 390 M) were included. The median age was 68 years (18-97). There were 279 (40.3%) young and 414 (59.7%) elderly patients. There was no difference between the groups in gender and mortality (p = 0.436, p = 0.932, respectively). Most of the co-morbid diseases were more common in the elderly except solid malignancies which were more common in young patients (p = 0.033). Long ICU stay, long hospital stay before ICU, high APACHE II and Charlson co-morbidity index scores, pneumonia, acute hepatic failure/coma, malignancy, acute hemodialysis, need for vasopressors, and invasive mechanical ventilation were independent predictors of ICU mortality. CONCLUSION: Age and gender were not found to be predictors of mortality. There was no survival advantage between young and elderly patients. Co-morbid diseases, apart from malignancy, had no effect on mortality. In developing countries, where patients with terminal illness and multiple co-morbid diseases are treated in the ICU, age should not be a determining factor in patient selection for ICU or in the treatment decisions to be applied to patients.
BACKGROUND: The individuals over 65 years old constitute an important patient population of medical intensive care units (ICUs). AIM: To evaluate the risk factors for mortality in a medical ICU consisting a group of patients with a large number of co-morbidities. METHODS: This is a retrospective study involving patients who were followed for more than 48 h. The cohort was divided into two groups according to age: (1) young, < 65 years old, and (2) elderly, ≥ 65 years old. RESULTS: A total of 693 patients (303 F, 390 M) were included. The median age was 68 years (18-97). There were 279 (40.3%) young and 414 (59.7%) elderly patients. There was no difference between the groups in gender and mortality (p = 0.436, p = 0.932, respectively). Most of the co-morbid diseases were more common in the elderly except solid malignancies which were more common in young patients (p = 0.033). Long ICU stay, long hospital stay before ICU, high APACHE II and Charlson co-morbidity index scores, pneumonia, acute hepatic failure/coma, malignancy, acute hemodialysis, need for vasopressors, and invasive mechanical ventilation were independent predictors of ICU mortality. CONCLUSION: Age and gender were not found to be predictors of mortality. There was no survival advantage between young and elderly patients. Co-morbid diseases, apart from malignancy, had no effect on mortality. In developing countries, where patients with terminal illness and multiple co-morbid diseases are treated in the ICU, age should not be a determining factor in patient selection for ICU or in the treatment decisions to be applied to patients.
Entities:
Keywords:
Age; Co-morbid diseases; Intensive care unit; Malignancy; Mortality
Authors: Mark Van Houdenhoven; Duy-Tien Nguyen; Marinus J Eijkemans; Ewout W Steyerberg; Hugo W Tilanus; Diederik Gommers; Gerhard Wullink; Jan Bakker; Geert Kazemier Journal: Crit Care Date: 2007 Impact factor: 9.097
Authors: Ignacio Martin-Loeches; Maria Consuelo Guia; Maria Sole Vallecoccia; David Suarez; Mercedes Ibarz; Marian Irazabal; Ricard Ferrer; Antonio Artigas Journal: Ann Intensive Care Date: 2019-02-04 Impact factor: 6.925