Hospitalization indications and its relation to mortality in very elderly patient in the ICU

• Autor(a) principal: Santos,Heitor Spagnol dos
• Data de Publicação: 2016
• Outros Autores: Andrighetti,Ana Paula, Manfredini,Maria Carolina, Rezende,Ederlon, Junior,João Manoel Silva, Ventura,Maurício de Miranda
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Geriatrics, Gerontology and Aging (Online)
• Texto Completo: https://ggaging.com/details/375
• topic: mortality; aged, 80 and over; intensive care units.

<p><b>OBJECTIVE:</b> This study aimed at evaluating mortality in very elderly patients admitted to the intensive care unit (ICU), from admission to 180 days later, considering hospitalization indications and severity scores at admission.<br> <b>METHODS:</b> An observational, longitudinal, retrospective study based on review of ICU medical records was performed at a tertiary care hospital. The patients in the study were aged 80 years or older, and were divided into three groups by admission criteria: clinical management, elective surgery, or emergency surgery. Exclusion criteria consisted of the inability to survey the variables studied: sex, severity scores (Sequential Organ Failure Assessment - SOFA, Acute Physiology and Chronic Health Evaluation - APACHE II; and Multiple Organ Dysfunction Score - MODS), duration of hospital stay and outcome.<br> <b>RESULTS:</b> A total of 186 patients were included, with a mean age of 84.47 ± 3.88 years. The mortality rates were 26.3% in the ICU and 45.7% during the hospital stay; 51.6% of patients were alive at day 180. Regression analysis showed that the major independent determinants of mortality for a period of up to 180 days were criteria for admission to the ICU [odds ratio = 3.417 (95%CI 1.502 - 7.776; p = 0.003)] and the SOFA score (OR = 1.240; 95%CI 1.080 - 1.420; p = 0.002).<br> <b>CONCLUSION:</b> Very elderly patients admitted to the ICU for clinical management and/ or who had the highest SOFA scores on admission had the worst prognosis in the 180 days following ICU admission.</p>