Upparakadiyala Rakesh, Singapati Subbarao, Sarkar Manuj Kumar, U Swathi
General Medicine, All India Institute of Medical Sciences (AIIMS) Mangalagiri, Mangalagiri, IND.
Pulmonary Medicine, Sri Venkateswara (S V) Medical College, Tirupathi, Tirupathi, IND.
Cureus. 2022 Feb 11;14(2):e22136. doi: 10.7759/cureus.22136. eCollection 2022 Feb.
Background In recent years, there is an increase in the proportion of the elderly population in the world. With an increase in patients' age, there is a change in the comorbidities and causes for Intensive care unit (ICU) admissions. More studies are needed to redefine healthcare delivery to elderly patients admitted to ICU. Aims The aims are to assess the disease pattern and outcome in elderly patients admitted to the Medical ICU and to determine factors affecting the outcomes in elderly patients admitted to the Medical ICU. Methods This was a retrospective cross-sectional study conducted in the Medical ICU of a tertiary care hospital for six months. Patients who met inclusion and exclusion criteria were included in this study. Data collected from medical records were statistically analysed. Results Out of 859 newly admitted patients to the Medical ICU, 196 (22.81%) were elderly patients (age > 60 years). The mean age of elderly patients was 69.8 ± 7.65 years. The mortality rate in elderly patients aged > 60 years was 36.70%, which was higher when compared to 23.60% in patients aged ≤ 60 years, and the correlation was statistically significant (p<0.0001). Neurological disorders (42.8%) were the most common cause of admissions, followed by renal disorders (13.26%), respiratory diseases (9.7%), and infections (9.18%). Deaths due to neurological disorders were most common (43.66%) followed by renal disorders (14.08%), infections (11.26%), and respiratory diseases (7%). The mean number of comorbidities in elderly patients was 1.99 ± 1.21. The mortality rate in elderly patients with more than three comorbidities was 56.52%, which was higher when compared to 33.52% in elderly patients with comorbidities ≤3, and the correlation was statistically insignificant (p=0.1275). The mean length of ICU stay in elderly patients was 9.14 ± 6.73 days. The length of stay in ICU was prolonged in patients with more number of comorbidities, which was statistically significant (p<0.0001). The mortality rate was higher in patients with prolonged length of stay, and the correlation was statistically significant (p=0.0013). Conclusion The insight over the proportion of older patients admitted to the ICU will enable policy-makers to plan accordingly. Mortality in elderly patients was high. Hence there is a need to redefine healthcare delivery to elderly patients in terms of triage and level of care in ICU. For better outcomes, risk categorisation can be done based on the number of comorbidities for optimal care. Exclusive geriatric intensive care units were needed for better care of elderly patients.
近年来，世界老年人口比例有所增加。随着患者年龄的增长，重症监护病房（ICU）收治患者的合并症和病因发生了变化。需要更多研究来重新定义针对入住ICU的老年患者的医疗服务。
评估入住内科ICU的老年患者的疾病模式和预后，并确定影响入住内科ICU的老年患者预后的因素。
这是一项在一家三级护理医院的内科ICU进行的为期六个月的回顾性横断面研究。符合纳入和排除标准的患者纳入本研究。对从病历中收集的数据进行统计分析。
在内科ICU新收治的859例患者中，196例（22.81%）为老年患者（年龄>60岁）。老年患者的平均年龄为69.8±7.65岁。年龄>60岁的老年患者死亡率为36.70%，高于年龄≤60岁患者的23.60%，且相关性具有统计学意义（p<0.0001）。神经系统疾病（42.8%）是最常见的入院原因，其次是肾脏疾病（13.26%）、呼吸系统疾病（9.7%）和感染（9.18%）。因神经系统疾病死亡最为常见（43.66%），其次是肾脏疾病（14.08%）、感染（11.26%）和呼吸系统疾病（7%）。老年患者的合并症平均数量为1.99±1.21。合并症超过三种的老年患者死亡率为56.52%，高于合并症≤3种的老年患者的33.52%，但相关性无统计学意义（p=0.1275）。老年患者在ICU的平均住院时间为9.14±6.73天。合并症数量较多的患者在ICU的住院时间延长，具有统计学意义（p<0.0001）。住院时间延长的患者死亡率较高，且相关性具有统计学意义（p=0.0013）。
了解入住ICU的老年患者比例将使政策制定者能够相应地进行规划。老年患者死亡率较高。因此，有必要在内科ICU的分诊和护理水平方面重新定义针对老年患者的医疗服务。为了获得更好的预后，可以根据合并症数量进行风险分类以提供最佳护理。需要设立专门的老年重症监护病房以更好地护理老年患者。
