Long term outcomes for elderly patients after emergency intensive care admission: A cohort study

Ged Dempsey, Dan Hungerford, Phil McHale, Lauren McGarey, Edward Benison and Ben Morton

PLOS ONE, 2020, vol. 15, issue 10, 1-14

Abstract: Background: Elderly patients (≥ 80 years of age) surviving an episode of critical illness suffer long-term morbidity and risk of mortality. Identifying high risk groups could assist in informing discussions with patients and families. Aim: To determine factors associated with long-term survival following ICU admission. Design: A cohort study of patients aged ≥ 80 years of age admitted to the ICU as an emergency. Methods: Patients admitted from January 2010 to December 2018 were included in the study. Primary outcome was five year survival. Mortality was assessed using a multivariable flexible parametric survival analysis adjusted for demographics, and clinically relevant covariates. Results: There were 828 patients. Mean age was 84 years (SD 3.2) and 419 (51%) were male. Patients were categorised into medical (423 (51%)) and surgical (405 (49%)) admissions. Adjusted hazard ratios (aHR) for mortality were highest for serum lactate (>8 mmol/l aHR 2.56 (C.I. 1.79–3.67)), lowest systolic blood pressure ( 8 mmol/l respectively). Relative survival for medical patients was below that expected for the general population for the duration of the study. Conclusion: Overall five-year survival was 27%. For medical and surgical patients it was 19% and 35% respectively. Survival at 30 days and one year was 61% and 46%. The presence of features of circulatory shock predicted poor short and long term survival.

Date: 2020
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0241244

DOI: 10.1371/journal.pone.0241244

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