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Intensive Care Medicine
Published in: Intensive Care Medicine 1/2014

01-01-2014 | Original

Outcome of elderly patients with circulatory failure

Authors: Patrick Biston, Cesar Aldecoa, Jacques Devriendt, Christian Madl, Didier Chochrad, Jean-Louis Vincent, Daniel De Backer

Published in: Intensive Care Medicine | Issue 1/2014

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Abstract

Purpose

The proportion of elderly patients admitted to the ICU is increasing. Mortality rates are known to increase with age but the impact of age on outcomes after circulatory shock has not been well defined.

Methods

We performed a secondary analysis of data from a large randomized trial comparing the effects of dopamine and norepinephrine on outcome in the ICU. Patients were separated into not old (<75 years), old (75–84 years), and very old (≥85 years).

Results

Of the 1,679 patients included in the initial trial, 1,651 had sufficient age data available: 1,157 (70 %) were not old, 410 (25 %) were old, and 84 (5 %) were very old. There were minor differences among the age groups in the APACHE II score calculated without the age component (not old, 17 ± 9; old, 18 ± 9; very old, 19 ± 9; p = 0.047), but SOFA scores were similar (not old, 9 ± 4; old, 9 ± 3; very old, 9 ± 3; p = 0.76). Mortality rates were higher in old and very old patients at 28 days, at hospital discharge, and after 6 and 12 months. Most very old patients were dead at 6 (92 %) and 12 months (97 %). Mortality rates increased with age in all types of shock. Using multivariable analysis, the risk of death was higher in very old patients as compared to not old (adjusted OR 0.33, 95 % CI 0.2–0.56, p < 0.001).

Conclusions

Ageing is independently associated with higher mortality rates in patients with circulatory failure, whatever the etiology. By 1 year after admission, most patients 85 years of age and older were dead.
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Metadata
Title
Outcome of elderly patients with circulatory failure
Authors
Patrick Biston
Cesar Aldecoa
Jacques Devriendt
Christian Madl
Didier Chochrad
Jean-Louis Vincent
Daniel De Backer
Publication date
01-01-2014
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine / Issue 1/2014
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-013-3121-7

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