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Age is not a risk factor in survival of severely ill patients with co-morbidities in a medical intensive care unit

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Abstract

Background

The individuals over 65 years old constitute an important patient population of medical intensive care units (ICUs).

Aim

To evaluate the risk factors for mortality in a medical ICU consisting a group of patients with a large number of co-morbidities.

Methods

This is a retrospective study involving patients who were followed for more than 48 h. The cohort was divided into two groups according to age: (1) young, < 65 years old, and (2) elderly, ≥ 65 years old.

Results

A total of 693 patients (303 F, 390 M) were included. The median age was 68 years (18–97). There were 279 (40.3%) young and 414 (59.7%) elderly patients. There was no difference between the groups in gender and mortality (p = 0.436, p = 0.932, respectively). Most of the co-morbid diseases were more common in the elderly except solid malignancies which were more common in young patients (p = 0.033). Long ICU stay, long hospital stay before ICU, high APACHE II and Charlson co-morbidity index scores, pneumonia, acute hepatic failure/coma, malignancy, acute hemodialysis, need for vasopressors, and invasive mechanical ventilation were independent predictors of ICU mortality.

Conclusion

Age and gender were not found to be predictors of mortality. There was no survival advantage between young and elderly patients. Co-morbid diseases, apart from malignancy, had no effect on mortality. In developing countries, where patients with terminal illness and multiple co-morbid diseases are treated in the ICU, age should not be a determining factor in patient selection for ICU or in the treatment decisions to be applied to patients.

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Author information

Authors and Affiliations

  1. Department of Internal Medicine, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey

    Seher Kır, Buğra Kaan Bahçeci, Eyüp Ayrancı, Murat Balkoca, Özkul Yılmaz Çolak & Esma Ayrancı

  2. Department of Internal Medicine, Nephrology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey

    Melda Dilek

Authors
  1. Seher Kır
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  2. Buğra Kaan Bahçeci
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  3. Eyüp Ayrancı
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  4. Murat Balkoca
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  5. Özkul Yılmaz Çolak
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  6. Esma Ayrancı
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Contributions

All authors contributed to the study conception and design, material preparation, data collection. Analysis was performed and first draft of the manuscript was written by Seher Kır, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Seher Kır.

Ethics declarations

This study was performed in line with the principles of the Declaration of Helsinki and approved by the Ethics Committee of Ondokuz Mayıs University (2019/330).

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The authors declare that they have no conflict of interest.

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Kır, S., Bahçeci, B.K., Ayrancı, E. et al. Age is not a risk factor in survival of severely ill patients with co-morbidities in a medical intensive care unit. Ir J Med Sci 190, 317–324 (2021). https://doi.org/10.1007/s11845-020-02298-0

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  • DOI: https://doi.org/10.1007/s11845-020-02298-0

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