Outcome of Critically Ill Oldest‐Old Patients (Aged 90 and Older) Admitted to the Intensive Care Unit

Abstract

OBJECTIVES: To compare the outcomes of critically ill oldest-old patients (> or = 90) with those of younger patients. DESIGN: Prospective cohort study. SETTING: General intensive care unit (ICU) of a tertiary care hospital in Athens, Greece. PARTICIPANTS: The oldest-old and younger patients. MEASUREMENTS: In-hospital and ICU mortality and stay, demographics, comorbidity, and complications. RESULTS: Of 5,505 consecutive patients admitted to the ICU, 60 (1.1%) were in the oldest-old group (aged 90-98). Their mean length of ICU and hospital stay+/-standard deviation was 5.3+/-6.8 and 23.3+/-35.7 days, respectively. ICU mortality was 20%. Total in-hospital mortality was 40%, compared with 8.9% (P=.001) in younger patients. Acute Physiology and Chronic Health Evaluation II score was independently associated with in-hospital mortality (odds ratio=1.18, 95% confidence interval=1.05-1.33). Of 24 oldest-old patients who died, 22 (91.7%) died in the ICU or in the ward within 30 days after ICU discharge. CONCLUSION: All-cause in-hospital mortality was higher in the oldest-old group than in younger patients, but the mortality of this cohort of patients did not seem to reach a figure that would make physicians, relatives, and healthcare administrators decide against ICU care in this population.