• Sara L Douglas, Barbara J Daly, Elizabeth E O'Toole, Carol G Kelley, and Hugo Montenegro.
• Case Western Reserve University, Frances Payne Bolton School of Nursing, Cleveland, OH 44106-4904, USA. sara.douglas@case.edu
• J Crit Care. 2009 Jun 1; 24 (2): 302-10.

PurposeChronically critically ill (CCI) patients use a disproportionate amount of resources, yet little research has examined outcomes for older CCI patients. The purpose of this study was to compare outcomes (mortality, disposition, posthospital resource use) between older (> or =65 years) and middle-aged (45-64 years) patients who require more than 96 hours of mechanical ventilation while in the intensive care unit.MethodsData from 2 prospective studies were combined for the present examination. In-hospital as well as posthospital discharge data were obtained via chart abstraction and interviews.ResultsOne thousand one hundred twenty-one subjects were enrolled; 62.4% (n = 700) were older. Older subjects had a 1.3 greater risk for overall mortality (from admission to 4 months posthospital discharge) than middle-aged subjects. The Acute Physiology Score (odds ratio [OR], 1.009), presence of diabetes (OR, 2.37), mechanical ventilation at discharge (OR, 3.17), and being older (OR, 2.20) were statistically significant predictors of death at 4 months postdischarge. Older subjects had significantly higher charges for home care services, although they spent less time at home (mean, 22.1 days) than middle-aged subjects (mean, 31.3 days) (P = .03).ConclusionOlder subjects were at higher risk of overall mortality and used, on average, more postdischarge services per patient when compared with middle-aged subjects.

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