Key result
Very elderly patients (>85 years) experienced a higher mortality rate during SICU compared to those aged 65-85 years (14.0% vs. 5.2%, p=0.026).
Why the study?
A rising number of surgical interventions are being performed in the very elderly, prompting an evaluation of the correlation between different age strata and functional status with surgical outcomes.
Does age >85 years compared to 65-85 years worsen clinical outcomes and mortality in elderly surgical patients admitted to the SICU?
Cohort (n=2,331)
No
Does age >85 years compared to 65-85 years worsen clinical outcomes and mortality in elderly surgical patients admitted to the SICU?
Very elderly surgical patients (>85 years) admitted to the SICU present with higher severity scores, more frequent non-elective surgeries, and significantly higher mortality compared to patients aged 65-85 years.
Very elderly (>85 y) SICU patients had higher mortality; retrospective data leaves open whether age independently predicts outcomes beyond severity.
Background The elderly population is an especially heterogeneous group of patients with a rising number of surgical interventions being performed in the very elderly patient. The aim of this study was to evaluate the correlation between different age strata and functional status with the surgical outcome of the elderly patient. Methods Retrospective cohort study conducted in a Surgical Intensive Care Unit (SICU), between 2006 and 2013. A total of 2331 surgical patients ≥ 65 years old were included. Patients were grouped according to age: Older Elderly Group (OEG: 65-85 years old); Very Elderly Group (VEG > 85 years old). Demographic and perioperative data were recorded. Revised Cardiac Risk Index, APACHE II and SAPS II scores were calculated and postoperative complications were documented. Variables were compared on univariate analysis. Results The incidence of the VEG was 5.4%. This group had a higher proportion of non-elective surgery (22.4% vs. 11.2%, p < 0.001), higher APACHE II (12.0 vs. 10.0, p < 0.001) and SAPS II (26.6 vs. 22.2, p < 0.001) scores, higher incidence of organ failure (24.6% vs. 17.6%, p = 0.048) and a higher mortality rate during SICU (14.0% vs. 5.2%, p = 0.026) and hospital stay (9.3% vs. 5.0%, p = 0.012). Conclusion We found that very elderly patients represented a significant proportion of patients admitted to the SICU. They had higher severity scores with a higher prevalence of organ failure and were more likely to undergo non-elective surgery. They had worse outcomes in regarding mortality during SICU and hospital stay.
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Silva et al. (2020) conducted a cohort in Surgical intervention in critically ill elderly (n=2,331). Very elderly age (> 85 years) vs. Older elderly age (65-85 years) was evaluated on Mortality during SICU (p=0.026). Very elderly patients (>85 years) experienced a higher mortality rate during SICU compared to those aged 65-85 years (14.0% vs. 5.2%, p=0.026).
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