Prognostic factors for 30-days mortality in eighty years aged and older critically ill patients: a single center retrospective cohort study

Authors: UMUT SABRİ KASAPOĞLU, OSMAN KAÇMAZ, ABDULLAH GÖK, MERİH YILDIZ EGLEN, HASAN ŞAYAN, FATİH ÇOLAK

Abstract: Background/aim: Nowadays, with the rise in average life expectancy, the rate of hospitalization of the older population in intensive care unit (ICU) is gradually increasing. Unfortunately, there are no ideal combination of prognostic factors predicting the mortality in older patients admitted to the ICU. In the present study, we aim to determine the prognostic factors and their impacts on short-time mortality in older critically ill patients. Materials and methods: This retrospective cohort study was performed between January 2019 and February 2020. We included 133 patients aged ≥80 years and hospitalized ≥24 h in the ICU. Results: A total of 133 critically ill patients enrolled in the present study. And, the median age of the patients was 85 (80-106) years. 30-days and overall ICU mortality rates were found 30.1% and 34.6%, respectively. The patients were grouped as survivors (n = 94) and nonsurvivors (n = 39). Hospital length of stay before the ICU admission was found significantly longer in nonsurvivors (p = 0.001). Sequential organ failure assessment (SOFA) score and acute physiology and chronic health evaluation-II (APACHE-II) score were significantly higher in nonsurvivors (p < 0.001, p < 0.001). Also, blood lactate level and glucose level were respectively significantly higher in nonsurvivors (p < 0.001, p = 0.006). We found that modified nutrition risk in critically ill (mNUTRIC) score and prehospital clinical frailty scale (CFS) were independent prognostic factors for the older critically ill patients (HR = 9.19, 95% CI=1.47-57.32, p = 0.018, HR = 20.16, 95% CI = 2.63-54.07, p =0.004). Conclusion: mNUTRIC score and prehospital CFS score were the most important prognostic factors in the admission of older patients to intensive care units.

Keywords: Older, ICU, frailty, modified NUTRIC score, prognostic factors, mortality

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