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Annals of Intensive Care
Published in: Annals of Intensive Care 1/2016

Open Access 01-12-2016 | Research

Treatment intensity and outcome of nonagenarians selected for admission in ICUs: a multicenter study of the Outcomerea Research Group

Authors: Maité Garrouste-Orgeas, Stéphane Ruckly, Charles Grégoire, Anne-Sylvie Dumesnil, Cécile Pommier, Samir Jamali, Dany Golgran-Toledano, Carole Schwebel, Christophe Clec’h, Lilia Soufir, Muriel Fartoukh, Guillaume Marcotte, Laurent Argaud, Bruno Verdière, Michael Darmon, Elie Azoulay, Jean-François Timsit

Published in: Annals of Intensive Care | Issue 1/2016

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Abstract

Background

Outcome of very elderly patients admitted in intensive care unit (ICU) was most often reported for octogenarians. ICU admission demands for nonagenarians are increasing. The primary objective was to compare outcome and intensity of treatment of octogenarians and nonagenarians.

Methods

We performed an observational study in 12 ICUs of the Outcomerea™ network which prospectively upload data into the Outcomerea™ database. Patients >90 years old (case patients) were matched with patients 80–90 years old (control patients). Matching criteria were severity of illness at admission, center, and year of admission.

Results

A total of 2419 patients aged 80 or older and admitted from September 1997 to September 2013 were included. Among them, 179 (7.9 %) were >90 years old. Matching was performed for 176 nonagenarian patients. Compared with control patients, case patients were more often hospitalized for unscheduled surgery [54 (30.7 %) vs. 42 (23.9 %), p < 0.01] and had less often arterial monitoring for blood pressure [37 (21 %) vs. 53 (30.1 %), p = 0.04] and renal replacement therapy [5 (2.8 %) vs. 14 (8 %), p = 0.05] than control patients. ICU [44 (25 %) vs. 36 (20.5 %), p = 0.28] or hospital mortality [70 (39.8 %) vs. 64 (36.4 %), p = 0.46] and limitation of life-sustaining therapies were not significantly different in case versus control patients, respectively. Only 16/176 (14 %) of case patients were transferred to a geriatric unit.

Conclusion

This multicenter study reported that nonagenarians represented a small fraction of ICU patients. When admitted, these highly selected patients received similar life-sustaining treatments, except RRT, than octogenarians. ICU and hospital mortality were similar between the two groups.
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Metadata
Title
Treatment intensity and outcome of nonagenarians selected for admission in ICUs: a multicenter study of the Outcomerea Research Group
Authors
Maité Garrouste-Orgeas
Stéphane Ruckly
Charles Grégoire
Anne-Sylvie Dumesnil
Cécile Pommier
Samir Jamali
Dany Golgran-Toledano
Carole Schwebel
Christophe Clec’h
Lilia Soufir
Muriel Fartoukh
Guillaume Marcotte
Laurent Argaud
Bruno Verdière
Michael Darmon
Elie Azoulay
Jean-François Timsit
Publication date
01-12-2016
Publisher
Springer Paris
Published in
Annals of Intensive Care / Issue 1/2016
Electronic ISSN: 2110-5820
DOI
https://doi.org/10.1186/s13613-016-0133-9

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