Factors associated with mortality, length of stay, and limitation of therapeutic effort in patients aged 80 years and older in a surgical ICU: A retrospective observational study.

OBJECTIVES

To describe the clinical characteristics of patients over 80 years admitted to the Surgical Intensive Care Unit (SICU) of Hospital de La Princesa, and to identify admission variables associated with mortality and prolonged hospital stay. As a secondary objective, we explored decisions regarding limitation of therapeutic effort (LTE), their predictors, and their impact on survival and length of stay.

MATERIAL AND

METHODS

Retrospective observational study including 100 patients over 80 years admitted to the SICU. Clinical, demographic, and prognostic variables were collected, including age, sex, type of surgery, SOFA and Charlson scores, nutritional status (CONUT), and frailty. Multivariate analysis was performed to identify factors associated with mortality, length of stay, and LTE.

RESULTS

Mean age was 85.8 years (SD ± 4.2). Thirty-day mortality was 16%, and mean ICU length of stay was 5.36 days (SD ± 8.2). Mechanical ventilation was the only factor independently associated with mortality (OR 16.6; 95% CI: 1.5-180.6). Development of sepsis and use of vasoactive drugs were associated with longer hospital stays (p < 0.05). LTE decisions were made in 68% of deceased patients, with no significant differences in survival or length of stay between patients with and without LTE.

CONCLUSIONS

Mechanical ventilation is the main predictor of mortality in patients over 80 years admitted to SICU. Sepsis and vasoactive support prolonged hospital stay. LTE decisions are frequent in this population, although no clear predictors for their application were identified.