• Daiv J Lown, Jonathon Knott, Thomas Rechnitzer, and Chris Maclsaac.
• Royal Melbourne Hospital, Melbourne, VIC, Australia. daiv.lown@mh.org.au
• Crit Care Resusc. 2013 Mar 1;15(1):49-55.

ObjectiveThe long-term outcomes of intensive care for the growing elderly cohort are not well defined. We explored the predictive factors for 12-month mortality in elderly patients who were admitted to an intensive care unit within 24 hours of emergency department (ED) presentation.Design, Setting And ParticipantsA retrospective cohort study of 506 patients aged 80 years and over who were admitted to the Royal Melbourne Hospital ICU within 24 hours of presentation to the ED, between 1 January 2005 and 1 December 2010.Main Outcome Measures And ResultsAfter multivariate regression analysis, independent risk factors for mortality 12 months after hospital discharge were the need for mechanical ventilation (odds ratio [OR], 5.16; 95% CI, 3.00-8.86), presence of acute renal failure (OR, 4.71; 95% CI, 2.04-10.84), age (OR, 1.07; 95% CI, 1.01-1.14), Glasgow coma score (GCS) (OR, 0.89; 95% CI, 0.84-0.93) and serum urea level (OR, 1.05; 95% CI, 1.02-1.07). Independent predictors for mortality in the ICU were the presence of acute renal failure (OR, 14.96; 95% CI, 6.50- 34.44), the need for mechanical ventilation (OR, 8.13; 95% CI, 2.77-23.89), and GCS (OR, 0.85; 95% CI, 0.79-0.90). Mortality in the ICU was 16.6%, and 12 months after hospital discharge was 46.3%.ConclusionsPhysiological parameters present on admission to the ICU including acute renal failure, the need for mechanical ventilation, a low GCS and high serum urea level, as well as age, have independent predictive value for 12-month mortality, but comorbidities were not predictive. This may help clinicians with decisions about who will benefit most from intensive care treatment.

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