Title: Mortality and physical status at hospital discharge in elderly critically ill patients
 
T. Tadokoro, T. Yatabe, A. Nishigaki, M. Yokoyama
 
Background: Because there is ongoing population aging, the age of patients admitted to the intensive care unit (ICU) is also higher. However, the evidence about outcomes in elderly patients is insufficient. We hypothesized that in-hospital mortality and physical function at hospital discharge in elderly patients might be worse compared with younger individuals. Therefore, we conducted a single center retrospective study.
Method: The study participants were consecutive patients who were admitted to our ICU and received mechanical ventilation for more than 24 hours. We divided the patients into two groups, according to age. Patients in group A were 74 years old or younger, and those in group B were 75 years old or older. The major outcome was in-hospital mortality, and secondary outcomes were the proportion of patients who were discharged home and good physical status at hospital discharge. We defined good physical status as walking and poor physical status as sitting and bed rest. We assessed each of these parameters using the non-paired t test, Mann–Whitney U test and chi-square test. P-values less than 0.05 were considered statistically significant. Data were reported as median [interquartile range] or percentage.
Findings: Two hundred and twenty patients met the inclusion criteria. There were 118 patients in group A and 102 patients in group B. The median age in both groups were 65 [55, 69] and 80 [77, 84] years (p < 0.0001). The length of ICU and hospital stay were not significantly different between the groups (5 [4, 9] vs. 7 [4, 10] days, p = 0.09; 36 [23, 55] vs. 39 [24, 58] days, p = 0.24, respectively). The overall hospital mortality in both groups were similar (19 vs. 25 %, p = 0.23). The proportion of patients who were discharged home and had good physical status at hospital discharge in group A were significantly higher than that in group B (72 vs. 37 %, p < 0.0001; 91 vs. 74 %, p = 0.004, respectively).
Conclusion: Although in-hospital mortality was similar between inpatients aged 75 years or older and those younger than 75 years, the elderly population were associated with a two-fold increase in the risk of discharged not to the home compared with others.

09 / Mortality and physical status at hospital discharge in elderly critically ill patients