Short and long-term prognosis of elderly patients (pts) subjected to invasive mechanical ventilation (IMV) in the intensive care unit (ICU)

Introduction: The global population is aging and as a result, the rate of hospitalizations and the demand for critical care services among older persons is certain to increase. Objectives: The primary objectives were to evaluate ICU and in-hospital (IH) mortality (MRT) rate of very old pts (age ≥80 years) admitted to ICU and subjected to IMV. The secondary objectives were to assess the functional capacity at discharge and the MRT rate at 1 year after discharge. Methods: Retrospective analysis of data collected from the hospital database from 2013 to 2016. All pts ≥80 years admitted to the ICU and submitted to IMV were included in the study. This patient sample was compared to a random sample of patients with age <80 years also subjected to IMV. Results: Sixty-two pts with ≥80 years were included and the random sample consisted of 50 pts with <80 years. Gender and primary diagnosis did not differ between both groups, but older patients showed higher dependence for daily living activities and Charlson Comorbidity Index at admission. The ICU MRT was higher in the group of patients ≥80 years (age ≥80: 52% vs age <80: 32%; p=0.039), as was IH MRT (65% vs 38%; p=0.006). In patients ≥80 years the odds ratio of death in ICU and IH was 2.27 (CI 1.04 to 4.92) and 2.97 (CI 1.37 to 6.42), respectively. We found no significant statistical difference between groups on functional capacity at discharge or MRT rate at 1 year after discharge. Conclusion: This study shows that very old pts have higher ICU and IH MRT rate, but there’s no difference on functional capacity at discharge or long-term MRT at 1 year.