Profile and outcome in elderly patients requiring mechanical ventilation

Purpose

To describe the profile and outcome in elderly requiring mechanical ventilation (MV) in ICU.

Methods

This cohort study included all consecutive patients with age ≥ 80 years admitted to the ICU between January 1998 and November 2001. All patients had age, gender, APACHE II at admission, MODS score on day 1, need of MV, length of stay (LOS) in ICU and hospital, occurrence of sepsis and septic shock, and ICU and hospital outcomes collected. Statistical analysis comparing patients who required mechanical ventilation or not were done by Mann–Whitney and chi-square, as indicated.

Results

There were 1769 admissions in the ICU during the study period, of whom 167 (9.4%) met age criteria for inclusion in the study. A group of 116 (70%) patients required MV. The mean age was 84.2 ± 4 years, ranging from 80 to 96 years. One hundred and five (63%) patients were females. The mean APACHE II score was 18 ± 7, mean total MODS score was 4.1 ± 3 on day 1. There were 80 (48%) patients with sepsis, of whom 49 (61%) had septic shock. The mean LOS in ICU and hospital was 10 ± 12 and 28 ± 28 days, respectively. Clinical causes were responsible for 117 (70%) admissions. The ICU and hospital mortality were 55% (n = 92) and 67% (n = 111). The Table compares the characteristics of the patients, regarding with the use of MV.

Table 1

Conclusion

The elderly requiring MV had a higher mortality, which could be explained by the severity of their illness expressed by higher scores APACHE II and MODS on admission and the occurrence of sepsis and septic shock. Our patients who needed MV in the elderly had a high incidence of septic shock, LOS in ICU and poor outcome.