Outcomes of elderly and very elderly patients admitted to intensive care unit for sepsis

Background: With a rapidly aging population, there is increasing number of elderly and very elderly patients admitted to intensive care unit (ICU) for sepsis. Aim: To evaluate the clinical characteristics, short- and long-term outcomes of these patients. Method: This was a retrospective cohort study of ICU patients admitted for sepsis between July 2015 and October 2016. Patients were divided into young (<65 years), elderly (65 to 79 years) and very elderly (≥80 years). Hospital and one-year mortality, ICU and hospital length of stay and functional status at hospital discharge were examined. Results: There were 668 patients. 37.3% were young, 43.1% were elderly and 19.6% were very elderly. Elderly and very elderly had more comorbidities. There was no difference in APACHE IIM (modified to exclude age points) (p=0.16) and SOFA score (p=0.54). Hospital mortality increased with age. Mortality was higher in very elderly (55.7%) versus young (39.4%) (p<0.01), and elderly (48.6%) versus young (p=0.03), but no difference was seen between very elderly and elderly (p=0.18). Similar findings were observed in one-year mortality. There was no difference in median ICU length of stay (5 days in all groups), but median hospital length of stay was significantly longer in elderly (20 days) compared to young (14 days) (p=0.01). There were 357 hospital survivors. Functional status at hospital discharge was worse with age, with lower proportion of independence in activities of daily living in very elderly (31.0%) and elderly (52.0%) compared to young (70.9%) (p<0.01 and p<0.01 respectively). Conclusion: Elderly and very elderly patients admitted to ICU for sepsis had considerably poorer outcomes with a higher burden of care.