Impact of mechanical ventilation in the elderly

Introduction

The need and length of mechanical ventilation (MV) in the elderly is accepted as an important determinant of mortality. The purpose of this study is to analyze the impact of MV on survival of elderly people.

Method

This is a retrospective survey of all patients aged ≥ 80 years admitted to the ICU from January 1997 to December 1999. The following data were studied: age, gender, APACHEII score, type of admission (clinical/surgical), need of MV, length of MV and ICU mortality. Statistical analysis were done by Student's t-test, Mann-Whitney and Χ² as indicated.

Results

There were 1441 admissions to the ICU during the period of the study, with 106 patients (7.5%) older than 80 years. The age varied from 80-94 years (84.1 ± 3.7 years), 53 (50%) patients were male, the mean APACHEII score was 18.9 ± 7.2, and the type of admission was clinical in 74 (69.8%) patients. Thirty-one (29.2%) patients did not use MV and 75 (70.8%) received MV. In the group who received MV, 25 (33.3%) patients were mechanically ventilated up to 3 days and 50 (66.7%) patients used MV longer. Global mortality rate was 60.4%. Analysis of MV and its length are shown in Tables 1 and 2.

Table 1 Use of MV and mortality

Table 2 Length of MV and mortality

Conclusion

Despite the fact that those patients who needed MV were more ill, its subgroups (regarding length of MV) have no difference on APACHEII score, making them comparable. Our data points that mortality was affected by the need and not by the length of MV in the elderly.