Objective: This study aimed to evaluate clinical and functional factors associated with one-year mortality after intensive care unit (ICU) discharge among ICU survivors aged 80 years and older, with particular emphasis on comorbidity burden and post-discharge dependency. Methods: This retrospective, single-center observational study included 131 ICU survivors aged ≥ 80 years who were discharged alive from the ICU between January 2023 and April 2025. Patients were categorized according to one-year survival status after ICU discharge as survivors (n = 63) and non-survivors (n = 68). Demographic characteristics, comorbidities, acute illness severity scores, ICU- and hospital-related variables, discharge characteristics, post-discharge care requirements, respiratory support status, and nutritional routes were analyzed. Multivariable logistic regression analysis was performed to identify factors independently associated with one-year mortality. Results: The one-year mortality rate after ICU discharge was 51.9%. Non-survivors were significantly older than survivors (85.41 ± 3.85 vs. 84.30 ± 4.26 years, p = 0.038). The Charlson Comorbidity Index (CCI) was significantly higher in non-survivors (5.69 ± 2.27 vs. 4.08 ± 2.07, p < 0.001) and remained independently associated with one-year mortality (OR = 1.432, 95% CI: 1.107–1.851; p = 0.006). Additionally, post-discharge care requirement was independently associated with increased mortality (OR = 6.35, 95% CI: 2.83–14.21; p < 0.001), while the presence of spontaneous breathing was associated with lower odds of mortality (OR = 0.32, 95% CI: 0.15–0.66; p = 0.002). ICU and hospital lengths of stay were longer in non-survivors, and vasopressor use was more frequent in this group. Survivors were more likely to be discharged home, were less likely to require post-discharge care, and had higher rates of spontaneous breathing. In contrast, non-survivors more frequently required post-discharge care and oxygen concentrator support. Conclusions: Among ICU survivors aged 80 years and older who were discharged alive from the ICU, one-year mortality after discharge was strongly associated with comorbidity burden and post-discharge dependency indicators. These findings highlight the importance of structured post-ICU follow-up, functional assessment, and individualized care planning for very elderly ICU survivors.
Gülen et al. (Wed,) studied this question.