Clinical features and disease progression of elderly patients at the ICU setting

Abstract

Objective: To describe and characterize a cohort of octogenarian patients admitted to the ICU of the University Central Hospital of Asturias (HUCA).

Design: Retrospective, observational and descriptive study of 14 months' duration.

Setting: Cardiac and Medical intensive care units (ICU) of the HUCA (Oviedo).

Participants: Patients over 80 years old who were admitted to the ICU for more than 24 h.

Interventions: None.

Main variables of interest: Age, sex, comorbidity, functional dependence, treatment, complications, evolution, mortality.

Results: The most frequent reasons for admission were cardiac surgery and pneumonia. The average admission stay was significantly longer in patients under 85 years of age (p = 0,037). 84,3% of the latter benefited from invasive mechanical ventilation compared to 46,2% of older patients (p = <0,001). Patients over 85 years of age presented greater fragility. Admission for cardiac surgery was associated with a lower risk of mortality (HR = 0,18; 95% CI (0,062-0,527; p = 0,002).

Conclusions: The results have shown an association between the reason for admission to the ICU and the risk of mortality in octogenarian patients. Cardiac surgery was associated with a better prognosis compared to medical pathology, where pneumonia was associated with a higher risk of mortality. Furthermore, a significant positive association was observed between age and frailty.

Keywords: Ancianos; Evolución; Evolution; Frail elderly; Intensive care units; Mortalidad; Mortality; Outcome; Pronóstico; Unidad de cuidados intensivos.