Rellos Konstantinos, Falagas Matthew E, Vardakas Konstantinos Z, Sermaides George, Michalopoulos Argyris
Intensive Care Unit, Henry Dunant Hospital, Athens, Greece.
J Am Geriatr Soc. 2006 Jan;54(1):110-4. doi: 10.1111/j.1532-5415.2005.00544.x.
To compare the outcomes of critically ill oldest-old patients (> or = 90) with those of younger patients.
Prospective cohort study.
General intensive care unit (ICU) of a tertiary care hospital in Athens, Greece.
The oldest-old and younger patients.
In-hospital and ICU mortality and stay, demographics, comorbidity, and complications.
Of 5,505 consecutive patients admitted to the ICU, 60 (1.1%) were in the oldest-old group (aged 90-98). Their mean length of ICU and hospital stay+/-standard deviation was 5.3+/-6.8 and 23.3+/-35.7 days, respectively. ICU mortality was 20%. Total in-hospital mortality was 40%, compared with 8.9% (P=.001) in younger patients. Acute Physiology and Chronic Health Evaluation II score was independently associated with in-hospital mortality (odds ratio=1.18, 95% confidence interval=1.05-1.33). Of 24 oldest-old patients who died, 22 (91.7%) died in the ICU or in the ward within 30 days after ICU discharge.
All-cause in-hospital mortality was higher in the oldest-old group than in younger patients, but the mortality of this cohort of patients did not seem to reach a figure that would make physicians, relatives, and healthcare administrators decide against ICU care in this population.
比较高龄危重症患者（≥90岁）与年轻患者的治疗结果。
前瞻性队列研究。
希腊雅典一家三级医院的综合重症监护病房（ICU）。
高龄患者和年轻患者。
住院期间及ICU内的死亡率和住院时间、人口统计学特征、合并症及并发症。
在连续入住ICU的5505例患者中，60例（1.1%）属于高龄组（年龄90 - 98岁）。他们在ICU和医院的平均住院时间±标准差分别为5.3±6.8天和23.3±35.7天。ICU死亡率为20%。住院总死亡率为40%，而年轻患者为8.9%（P = 0.001）。急性生理与慢性健康状况评分系统II（APACHE II）与住院死亡率独立相关（比值比 = 1.18，95%置信区间 = 1.05 - 1.33）。在24例死亡的高龄患者中，22例（91.7%）在ICU出院后30天内死于ICU或病房。
高龄组的全因住院死亡率高于年轻患者，但该组患者的死亡率似乎未达到使医生、亲属和医疗管理者决定不给予该人群ICU治疗的程度。
