Medical Intensive Care for the Elderly
A Study of Current Use, Costs, and Outcomes
- Edward W. Campion, MD;
- Albert G. Mulley, MD, MPP;
- Richard L. Goldstein, MA, MD;
- G. Octo Barnett, MD;
- George E. Thibault, MD
- From the Geriatrics Unit (Dr Campion), the Medical Practices Evaluation Unit (Drs Mulley, Goldstein, and Thibault), and the Laboratory of Computer Science (Dr Barnett), Department of Medicine, Massachusetts General Hospital, Boston. Dr Mulley is a Henry J. Kaiser Family Foundation Faculty Scholar in General Internal Medicine.
Abstract
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.
(JAMA 1981;246:2052-2056)
Footnotes
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Reprint requests to Medical Practices Evaluation Unit, Massachusetts General Hospital, Boston, MA 02114 (Dr Mulley).
