A Retrospective Analysis of Elderly Patients: Admitted Directly from the Emergency Department to the Intensive Care Unit for Medical Reasons
Authors
##plugins.themes.bootstrap3.article.sidebar##
##plugins.themes.bootstrap3.article.main##
Abstract
Objective: In the literature, the mortality rates have been reported to be higher in elderly patients admitted for medical reasons. We aimed to investigate the epidemiologic characteristics and clinical outcomes of these patients. Methods: In this study, records of medical patients aged ≥65 years admitted to ICU from ED, between Jan 2015-2018, were retrospectively reviewed. Demographic data, comorbidities, the main reason for the ICU admission, Acute Physical and Chronic Health Evaluation II (APACHE II) score, admission time of ED (Day time/ Off hours), and the transferred time to ICU were recorded. The following parameters were recorded: Requirement of mechanical ventilation (MV), duration of MV, requirement of vasopressors or renal replacement therapy (RRT), ICU Length of Stay, and ICU mortality. Results: A total of 134 patients were evaluated. The mean age of them was 77.56 ± 11.6 years. 43 patients were admitted during the day time. Most common reasons for ICU admission were respiratory failure and neurologic disorders. 63 patients died in the ICU. APACHE II score, requirement of MV, and vasopressors, ICU Length of Stay, and duration of MV were higher in nonsurvivors. However, transferred time was shorter in nonsurvivors. There was a negative correlation between mortality and transferred time, but a positive correlation was found with APACHE II score. Conclusions: The most interesting result of our study was that the transferred time of the nonsurvivors was shorter than the surviving patients. We think that this depends on the rapid admission of critical patients to the ICU, since ED in our hospital does not have the necessary technical equipment for the follow-up of these patients.
##plugins.themes.bootstrap3.article.details##
Copyright (c) 2025 Müge Arıkan
This work is licensed under a Creative Commons Attribution 4.0 International License.
Creative Commons License All articles published in Annals of Medicine and Medical Sciences are licensed under a Creative Commons Attribution 4.0 International License.
Müge Arıkan, Department of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Karabuk University, Karabuk, Turkey.
Department of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Karabuk University, Karabuk, Turkey.
[1] Lerolle N, Trinquart L, Bornstain C, et al. Increased intensity of treatment and decreased mortality in elderly patients in an intensive care unit over a decade. Crit Care Med. 2010 ;38(1):59-64.
[2] Tabah A, Philippart F, Timsit JF, et al. Quality of life in patients aged 80 or over after ICU discharge. Crit Care. 2010; 14(1): R2
[3] Roch A, Wiramus S, Pauly V, et al. Long-term outcome in medical patients aged 80 or over following admission to an intensive care unit. Crit Care. 2011;15(1): R36.
[4] Belayachi J, El khayari M, Dendane T, Madani N, Abidi K. Factors predicting mortality in elderly patients admitted to a Moroccan medical intensive care unit. South Afr J Crit Care.2012;28:22-7.
[5] Sodhi K, Singla MK, Shrivastava A, Bansal N. Do Intensive Care Unit treatment modalities predict mortality in geriatric patients: An observational study from an Indian Intensive Care Unit. Indian J Crit Care Med. 2014; 18(12): 789-795.
[6] Stein FD, Barros RK, Feitosa FS, Toledo DO, Silva Junior JM, Isola AM. Prognostic factors in elderly patients admitted in the intensive care unit. Revista Brasileira de Terapia Intensiva. 2019; 21(3), 255-261.
[7] Rellos K, Falagas ME, Vardakas KZ, Sermaides G, Michalopoulos A. Outcome of critically ill oldest-old patients (aged 90 and older) admitted to the intensive care unit. J Am Geriatr Soc. 2006;54(1):110-4.
[8] Ip SP, Leung YF, Ip CY, Mak WP. Outcomes of critically ill elderly patients: Is high-dependency care for geriatric patients worthwhile? Crit Care Med. 1999; 27:2351-7.
[9] van den Noortgate N, Vogelaers D, Afschrift M, Colardyn F. Intensive care for very elderly patients: Outcome and risk factors for in-hospital mortality. Age Ageing. 1999; 28:253-6.
[10] Orsini J, Butala A, Salomon S, et al. Prognostic factors associated with adverse outcome among critically ill elderly patients admitted to the intensive care unit. Geriatr Gerontol Int.2014; 15(7):889-94.