Assessment of geriatrics outcomes in the cardiac intensive care unit

Abstract

Objective: Critically ill older adults greater than or equal to 80 years old are routinely admitted to contemporary cardiac intensive care units (CICU). Little has been reported about their outcomes when compared to the general CICU population. The primary aim of this study was to compare the mortality, length-of-stay, and disposition outcomes of elderly patients (greater or equal to 80 years old) admitted to the CICU with a younger cohort (less than 80 years old).

Methods and Results: A single-center, retrospective cohort study was conducted including 6,194 adult patients admitted to a cardiovascular intensive care unit in Newark, Delaware, from July 1, 2012, to June 30, 2019. Coronary intensive care unit (CICU) mortality, CICU length-of-stay and discharge disposition were compared between elderly patients (greater than or equal to 80 years old) and younger patients (less than 80 years old), adjusted for comorbidities.

We observed increased mortality for elderly patients (OR 1.686, CI 1.361-2.090, p<0.001) compared with patients less than 80 years old, even after adjusting for comorbidities. Median length of stay was not statistically different between the two groups. However, the elderly patients were significantly more likely to be discharged to a facility, such as a skilled nursing facility, than those less than 80 years old (26.8% versus 12.5%, respectively, p<0.001).

Conclusions: Among patients admitted to the CICU, elderly patients have higher mortality rates than those less than 80 years old. Advanced age (greater or equal to 80 years old) was not a reliable predictor of outcome in the CICU. A large proportion of elderly patients are not able to live independently at home after CICU admissions.

Key Words: octogenarians, nonagenarians, cardiac intensive care unit, elderly, ICU mortality