Medical intensive care for the elderly. A study of current use, costs, and outcomes
E. W. Campion, A. G. Mulley, R. L. Goldstein, G. O. Barnett and G. E. Thibault
All admissions (2,693) to a medical intensive and coronary care unit
(ICU/CCU) during a two-year period were reviewed to compare indications for
admission, major interventions, and outcomes for elderly patients with
those for younger patients. Once admitted to the ICU/CCU, older patients
were more likely to receive major life-support interventions such as
mechanical ventilation but less likely to survive. Major interventions were
used in 32% of patients aged 75 years or older, in 26% of those 65 to 74
years, and in 22% of those 55 to 64 years. Nonetheless, elderly patients
had no longer mean lengths of stay and no greater mean hospital charges.
Hospital mortality for the oldest patients was 16%, compared with 14% and
8% for the younger age groups. Cumulative mortality one year after
discharge for those older than 75 years was 44%. Elderly hospital survivors
returned to their preadmission living situation but did not regain their
preadmission activity level.
