Factors affecting the outcome of older adults followed in the intensive care unit according to age stages

Abstract

Background/Aim: Increased frailty with age along with an increase in comorbidities heighten mortality in intensive care units. According to the World Health Organization, old age is divided into three stages: 65–74 years, 75–84 years, and 85 years and older. The lengthened human lifespan leads to a growth in the number of elderly patients in intensive care units, and the need to know the factors associated with prognosis in the three stages of old age. We aimed to define factors affecting mortality in these three stages of aging and the factors that can help predict prognoses. Methods: In this retrospective cohort, data of patients over the age of 65 who were admitted to the intensive care unit of Bolu Izzet Baysal State Hospital between January 2016 and December 2020 were recorded using the hospital's automation system. Demographic data, blood tests, diagnoses and inflammatory biomarkers, such as RDW, NLR, and CAR were recorded. The data were analyzed using SPSS, and P<0.05 was considered significant. Results: In this study, 46.2% of the 1566 patients died. The most common diagnosis for admission to the intensive care unit was sepsis, and the most common comorbidity was hypertension. While neurological impairment (P<0.001), malignancy (P=0.006), and cardiac disease (P=0.004) were associated with mortality in all three stages of old age, chronic obstructive pulmonary disease was associated with mortality in the 85 years and older age group (P=0.011) and diabetes in those aged 65–74 years and 75–84 years. The APACHE II score (P<0.001) and red cell distribution width (P<0.001) were highly effective in predicting prognoses in all three stages of old age. Conclusion: In examining the factors associated with mortality in older age intensive care unit patients, we found that the APACHE II score and red cell distribution width were effective in establishing prognoses for all age groups.