What is the clinical evidence from this study?

Study design: Observational. Population: Cardiac intensive care unit admission (n=35265). Intervention: Older age (≥85 years) vs. Age <65 years. Primary outcome: In-hospital mortality (OR 1.95, 95% CI 1.72-2.22).

What does this research mean for the field?

Compared to patients under 65 years, those aged 85 years and older admitted to the cardiac intensive care unit have a higher risk of in-hospital mortality, with an even steeper age-related increase in mortality among cardiac arrest patients. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The aim is to describe clinical characteristics, therapies, and outcomes for older patients in CICUs compared to younger adults.

June 19, 2026Open Access

Clinical Characteristics and Outcomes of Older Patients Admitted to the Cardiac Intensive Care Unit

Q: What are the key findings of this study?

Compared to patients <65 years, those aged ≥85 years had a higher risk of in-hospital mortality (adjusted OR 1.95; 95% CI 1.72-2.22), with a steeper increase among cardiac arrest patients.

Q: What does this research mean for the field?

Compared to patients under 65 years, those aged 85 years and older admitted to the cardiac intensive care unit have a higher risk of in-hospital mortality, with an even steeper age-related increase in mortality among cardiac arrest patients. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

The aim is to describe clinical characteristics, therapies, and outcomes for older patients in CICUs compared to younger adults.

Key Result

Compared to patients <65 years, those aged ≥85 years had a higher risk of in-hospital mortality (adjusted OR 1.95; 95% CI 1.72-2.22), with a steeper increase among cardiac arrest patients.

Key Points

The aim is to describe clinical characteristics, therapies, and outcomes for older patients in CICUs compared to younger adults.
Multicenter registry study with data from 35,265 admissions at 50 sites between 2017 and 2024.
Patients aged <65, 65-<75, 75-<85, and ≥85 years were analyzed.
Outcomes assessed included in-hospital mortality and length of stay, adjusted for key variables like SOFA score and kidney function.
Patients aged ≥85 years had a 1.95 adjusted odds ratio for in-hospital mortality compared to those <65 years.
Mortality risk increased significantly with age among cardiac arrest patients, reaching 3.09 for patients ≥85 years.
Only 5.5% of patients aged ≥85 received mechanical circulatory support, indicating potential treatment gaps.

Study Design

Type

Observational (n=35,265)

Multicenter

Yes

Structured PICO

Does older age increase in-hospital mortality in patients admitted to the CICU?

Population

35,265 consecutive medical admissions to cardiac intensive care units across 50 sites, categorized by age to compare outcomes of older versus younger adults.

Exposure

Older age groups (65-<75, 75-<85, and ≥85 years)

Comparator

Younger adults (<65 years)

Outcome

CICU and in-hospital mortality and length of stayhard clinical

Patients aged ≥85 years in contemporary CICUs experience survival comparable to those aged 75-<85 years, except in the setting of cardiac arrest, supporting consideration of factors beyond chronological age in triage.

Main Result

Odds Ratio: 1.95 (95% CI 1.72–2.22)

Abstract

BACKGROUND: Contemporary data characterizing older adults admitted to cardiac intensive care units (CICUs) across diverse indications are limited. OBJECTIVES: The objective of the study was to describe the clinical characteristics, critical care therapies, and in-hospital outcomes of older patients admitted to the CICU compared with younger adults. METHODS: The Critical Care Cardiology Trials Network is a multicenter, international registry of CICUs. Between 2017 and 2024, participating centers contributed annual ≥2-month snapshots of consecutive medical CICU admissions. Admissions were categorized into 4 age groups: <65, 65-<75, 75-<85, and ≥85 years. Outcomes included CICU and in-hospital mortality and length of stay. Multivariable models adjusted for sex, illness severity (SOFA score), lactate, and kidney function. RESULTS: Among 35,265 admissions from 50 sites, 44%, 27%, 21%, and 9% were aged <65, 65-<75, 75-<85, and ≥85 years, respectively. Acute coronary syndrome was the most common admission diagnosis among all age groups. Patients aged ≥85 years had the lowest use of mechanical circulatory support (5.5%), which consisted exclusively of intra-aortic balloon pumps. Relative to patients <65 years, adjusted ORs of in-hospital mortality were 1.53 (1.40-1.67) for 65-<75 years, 1.83 (1.67-2.01) for 75-<85 years, and 1.95 (1.72-2.22) for ≥85 years. Among cardiac arrest patients the increase in mortality with age was steeper, reaching 3.09 (2.24-4.26) for patients ≥85 years. CONCLUSIONS: Patients ≥85 years in contemporary CICUs experience survival comparable to those aged 75-<85 years, except in the setting of cardiac arrest. These findings support consideration of factors beyond chronological age in CICU triage and treatment decisions.

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