A Retrospective Analysis of Elderly Patients: Admitted Directly from the Emergency Department to the Intensive Care Unit for Medical Reasons

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.