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Arch Gerontol Geriatr. 2009 Sep-Oct;49(2):294-7. doi: 10.1016/j.archger.2008.11.001. Epub 2008 Dec 31.

Old patients in intensive care unit (ICU): what decisions to make?

Author information

1
Anesthesiology and Resuscitation Department, Santa Maria della Misericordia Hospital, S. Andrea delle Fratte, I-06156 Perugia, Italy. antoniogalzerano@libero.it

Abstract

This report is aimed at identifying and suggesting a decision-making approach to handle old patients in ICUs in the light of current epidemiological findings and literature. We reviewed the data provided by the GIVITI network on 107,459 patients admitted to 150 Italian ICUs between 2000 and 2005; patients were divided into age groups (18-65 years: group I; 66-75 years: group II; 76-85 years: group III; > or =85 years: group IV). Comorbidities were recorded on admission in all groups [I (62.2%), II (92.2%), III (94.9%) and IV (94.5%), respectively]. Therapeutic means were virtually applied in the same way to all groups under examination [I (82.1%), II (83.9%), III (85.9%) and IV (83.5%), respectively]. Mortality in ICU was higher in group IV (27.2%), followed by groups III (24.3%), II (19.1%) and I (13.2%). The multivariate logistic regression analysis of GIVITI and some reviewed studies suggest that age is an independent mortality factor; however, current literature is controversial. The choice of admitting and treating old patients in ICUs should result from a balance between clinical and ethical factors.

PMID:
19118908
DOI:
10.1016/j.archger.2008.11.001
[Indexed for MEDLINE]

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