Tags

Type your tag names separated by a space and hit enter

Very old patients admitted to intensive care in Australia and New Zealand: a multi-centre cohort analysis.
Crit Care 2009; 13(2):R45CC

Abstract

INTRODUCTION

Older age is associated with higher prevalence of chronic illness and functional impairment, contributing to an increased rate of hospitalization and admission to intensive care. The primary objective was to evaluate the rate, characteristics and outcomes of very old (age >or= 80 years) patients admitted to intensive care units (ICUs).

METHODS

Retrospective analysis of prospectively collected data from the Australian New Zealand Intensive Care Society Adult Patient Database. Data were obtained for 120,123 adult admissions for >or= 24 hours across 57 ICUs from 1 January 2000 to 31 December 2005.

RESULTS

A total of 15,640 very old patients (13.0%) were admitted during the study. These patients were more likely to be from a chronic care facility, had greater co-morbid illness, greater illness severity, and were less likely to receive mechanical ventilation. Crude ICU and hospital mortalities were higher (ICU: 12% vs. 8.2%, P < 0.001; hospital: 24.0% vs. 13%, P < 0.001). By multivariable analysis, age >/= 80 years was associated with higher ICU and hospital death compared with younger age strata (ICU: odds ratio (OR) = 2.7, 95% confidence interval (CI) = 2.4 to 3.0; hospital: OR = 5.4, 95% CI = 4.9 to 5.9). Factors associated with lower survival included admission from a chronic care facility, co-morbid illness, nonsurgical admission, greater illness severity, mechanical ventilation, and longer stay in the ICU. Those aged >or= 80 years were more likely to be discharged to rehabilitation/long-term care (12.3% vs. 4.9%, OR = 2.7, 95% CI = 2.6 to 2.9). The admission rates of very old patients increased by 5.6% per year. This potentially translates to a 72.4% increase in demand for ICU bed-days by 2015.

CONCLUSIONS

The proportion of patients aged >or= 80 years admitted to intensive care in Australia and New Zealand is rapidly increasing. Although these patients have more co-morbid illness, are less likely to be discharged home, and have a greater mortality than younger patients, approximately 80% survive to hospital discharge. These data also imply a potential major increase in demand for ICU bed-days for very old patients within a decade.

Authors+Show Affiliations

Department of Intensive Care, Austin Hospital, Studley Road, Heidelberg, VIC 3084, Australia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19335921

Citation

Bagshaw, Sean M., et al. "Very Old Patients Admitted to Intensive Care in Australia and New Zealand: a Multi-centre Cohort Analysis." Critical Care (London, England), vol. 13, no. 2, 2009, pp. R45.
Bagshaw SM, Webb SA, Delaney A, et al. Very old patients admitted to intensive care in Australia and New Zealand: a multi-centre cohort analysis. Crit Care. 2009;13(2):R45.
Bagshaw, S. M., Webb, S. A., Delaney, A., George, C., Pilcher, D., Hart, G. K., & Bellomo, R. (2009). Very old patients admitted to intensive care in Australia and New Zealand: a multi-centre cohort analysis. Critical Care (London, England), 13(2), pp. R45. doi:10.1186/cc7768.
Bagshaw SM, et al. Very Old Patients Admitted to Intensive Care in Australia and New Zealand: a Multi-centre Cohort Analysis. Crit Care. 2009;13(2):R45. PubMed PMID: 19335921.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Very old patients admitted to intensive care in Australia and New Zealand: a multi-centre cohort analysis. AU - Bagshaw,Sean M, AU - Webb,Steve A R, AU - Delaney,Anthony, AU - George,Carol, AU - Pilcher,David, AU - Hart,Graeme K, AU - Bellomo,Rinaldo, Y1 - 2009/04/01/ PY - 2008/11/29/received PY - 2009/03/03/revised PY - 2009/04/01/accepted PY - 2009/4/2/entrez PY - 2009/4/2/pubmed PY - 2009/9/9/medline SP - R45 EP - R45 JF - Critical care (London, England) JO - Crit Care VL - 13 IS - 2 N2 - INTRODUCTION: Older age is associated with higher prevalence of chronic illness and functional impairment, contributing to an increased rate of hospitalization and admission to intensive care. The primary objective was to evaluate the rate, characteristics and outcomes of very old (age >or= 80 years) patients admitted to intensive care units (ICUs). METHODS: Retrospective analysis of prospectively collected data from the Australian New Zealand Intensive Care Society Adult Patient Database. Data were obtained for 120,123 adult admissions for >or= 24 hours across 57 ICUs from 1 January 2000 to 31 December 2005. RESULTS: A total of 15,640 very old patients (13.0%) were admitted during the study. These patients were more likely to be from a chronic care facility, had greater co-morbid illness, greater illness severity, and were less likely to receive mechanical ventilation. Crude ICU and hospital mortalities were higher (ICU: 12% vs. 8.2%, P < 0.001; hospital: 24.0% vs. 13%, P < 0.001). By multivariable analysis, age >/= 80 years was associated with higher ICU and hospital death compared with younger age strata (ICU: odds ratio (OR) = 2.7, 95% confidence interval (CI) = 2.4 to 3.0; hospital: OR = 5.4, 95% CI = 4.9 to 5.9). Factors associated with lower survival included admission from a chronic care facility, co-morbid illness, nonsurgical admission, greater illness severity, mechanical ventilation, and longer stay in the ICU. Those aged >or= 80 years were more likely to be discharged to rehabilitation/long-term care (12.3% vs. 4.9%, OR = 2.7, 95% CI = 2.6 to 2.9). The admission rates of very old patients increased by 5.6% per year. This potentially translates to a 72.4% increase in demand for ICU bed-days by 2015. CONCLUSIONS: The proportion of patients aged >or= 80 years admitted to intensive care in Australia and New Zealand is rapidly increasing. Although these patients have more co-morbid illness, are less likely to be discharged home, and have a greater mortality than younger patients, approximately 80% survive to hospital discharge. These data also imply a potential major increase in demand for ICU bed-days for very old patients within a decade. SN - 1466-609X UR - https://www.unboundmedicine.com/medline/citation/19335921/Very_old_patients_admitted_to_intensive_care_in_Australia_and_New_Zealand:_a_multi_centre_cohort_analysis_ L2 - https://ccforum.biomedcentral.com/articles/10.1186/cc7768 DB - PRIME DP - Unbound Medicine ER -