The Association of Age With Short-Term and Long-Term Mortality in Adults Admitted to the Intensive Care Unit

Author:

Seethala Raghu R.12,Blackney Kevin3,Hou Peter12,Kaafarani Haytham M. A.4,Yeh Daniel Dante4,Aisiku Imoigele15,Tainter Christopher67,deMoya Marc4,King David4,Lee Jarone48

Affiliation:

1. Department of Emergency Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

2. Surgical Intensive Care Unit, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

3. Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

4. The Division of Trauma, Emergency Surgery and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

5. Medical Intensive Care Unit, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

6. Department of Emergency Medicine, UC San Diego Health System, UC San Diego School of Medicine, San Diego, CA, USA

7. Division of Critical Care, Department of Anesthesiology, UC San Diego Health System, UC San Diego School of Medicine, San Diego, CA, USA

8. Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

Abstract

Background: Based on the current literature, it is unclear whether advanced age itself leads to higher mortality in critically ill patients or whether it is due to the greater number of comorbidities in the elderly patients. We hypothesized that increasing age would increase the odds of short-term and long-term mortality after adjusting for baseline comorbidities in intensive care unit (ICU) patients. Methods: We performed a retrospective cohort study of 57 160 adults admitted to any ICU over 5 years at 2 academic tertiary care centers. Patients were divided into age-groups, 18 to 39, 40 to 59, 60 to 79, and ≥80. The primary outcomes were 30-day and 365-day mortality. Results were analyzed with multivariate logistic regression adjusting for demographics and the Elixhauser-van Walraven Comorbidity Index. Results: The adjusted 30-day mortality odds ratios (ORs) were 1.39 (95% confidence interval [CI]: 1.21-1.60), 2.00 (95% CI: 1.75-2.28), and 3.33 (95% CI: 2.90-3.82) for age-groups 40 to 59, 60 to 79, and ≥80, respectively, using the age-group 18 to 39 as the reference. The adjusted 365-day mortality ORs were 1.46 (95% CI: 1.32-1.61), 2.10 (95% CI: 1.91-2.31), and 2.96 (95% CI: 2.67-3.27). Conclusion: In critically ill patients, increasing age is associated with higher odds of short-term and long-term death after correcting for existing comorbidities.

Publisher

SAGE Publications

Subject

Critical Care and Intensive Care Medicine

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