Medical intensive care for the elderly. A study of current use, costs, and outcomes.

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.