Factors Associated with the Outcome of Older Patients Admitted in Geriatric Intensive Care Unit

Abstract

Objective: To determine the factors associated with the outcome of older patients admitted in Geriatric Intensive Care Unit. Materials and Methods: This cross-sectional, observational study was conducted in the Geriatric Intensive Care Unit of the Department of Geriatric Medicine, Madras Medical College, Chennai. one hundred and seventy two patients, aged 60 and above, admitted in the Geriatric ICU during the period of 6 months, from January 2017 to June 2017, were selected to participate in this study. Data regarding age, sex, number of comorbidities, major organ system involved, duration of stay and procedures underwent in the ICU were collected and analyzed. Results: Out of the 172 samples, 92 were males, and 80 were females. The mean age of the study population was 70.1 ± 8.3 years. We found no association between age and survival (p=0.581), gender and survival (p=0.298). 30.2% of the samples who expired had four comorbidities. We found a statistically significant association between the number of comorbidities and outcome (p<0.008). Around 44 patients (25.6%) had respiratory problems, and it was the commonest cause of admission to ICU in this study. We found no association between major system involved and outcome (p=0.089). Sixty of the study participants (34.9%) needed mechanical ventilatory support. We found a statistical significance between procedure underwent and outcome (p<0.001). 57.5% of the study participants stayed in the GICU up to 1 week. We found a statistical significance between the duration of stay and outcome (p=0.022). In this study, 71.5% of the study participants survived, 3.5% of them went against medical advice, and 25% of them expired. Conclusion: In this study, the outcome of older patients admitted in Geriatric Intensive Care Unit depended on the number of preexisting comorbidities, length of stay and procedure underwent during the ICU stay but not the chronological age. In this study, only one in four died after undergoing treatment in the Geriatric Intensive care unit. Geriatric intensive care services can improve the outcome of older patients admitted with a critical illness.

Clinical Profile and Factors Affecting Outcomes in Elderly Patients Admitted to the Medical Intensive Care Unit of a Tertiary Care Hospital

“…In our study, the proportion of elderly patients admitted to ICU was 22.81% of total admissions. In our study, the mean age of the elderly patients admitted to ICU was 69.8 ±7.65 years which correlated with the studies conducted by Thangam et al (70.01± 8 years) and Lankoandé et al (71.7± 6 years) [ 7 , 8 ]. The mortality rate in the study population was 36.7%, which was lower when compared to 45.1% in a study conducted by Schein et al [ 9 ].…”

“…In our study, CVAs account for 27.50% of admissions, which is similar to 27.4% in a study conducted by Lankoandé et al [8]. In our study, admissions in elderly patients with cardiac disease were 7.14%, which was less when compared to 24.4% in a study conducted by Thangam et al [7]. In SVRRGG hospital where this study was conducted, Acute myocardial infarction cases were admitted to a dedicated Intensive cardiac care unit resulting in a smaller number of cardiac diseases in our study.…”

“…In SVRRGG hospital where this study was conducted, Acute myocardial infarction cases were admitted to a dedicated Intensive cardiac care unit resulting in a smaller number of cardiac diseases in our study. In the present study, 43.66% of deaths were due to neurological disorders, which were high when compared to 16.3% in a study by Thangam et al [7].…”

“…Outcome (n) [7,8]. The mortality rate in the study population was 36.7%, which was lower when compared to 45.1% in a study conducted by Schein et al [9].…”

“…Only a few Indian studies researched this issue. Thangam et al conducted a study to determine the factors associated with the outcome of older patients admitted to the Geriatric ICU of a south Indian hospital [ 7 ]. Thangam et al’s study conclude that the outcome depends on the number of comorbidities and duration of stay.…”