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Is increasing age associated with mortality in the critically ill elderly.

INTRODUCTION
Age has been cited as a predictor of mortality in the intensive care unit (ICU) and suggested as a criterion for rationing resources. We investigated the association of age with both ICU mortality and hospital mortality.


MATERIALS AND METHODS
Patients admitted in 1998 to our Medical ICU (MICU) were retrospectively analysed by stratifying them into four groups: the reference group (55-64 years), the young old (65-74 years), the old old (75-84 years) and the oldest old (more than 85 years). The statistical association of age with ICU mortality and total hospital mortality was determined whilst controlling for the APACHE II(M) score (APACHE II score modified to exclude points for age), the number of organ failures and the presence of a high risk admitting diagnosis.


RESULTS
After controlling for disease severity, the ICU mortality and the total hospital mortality were not associated with age. The total hospital mortality was associated with the APACHE II(M) score (Odds ratio (OR), 1.08; 95% Confidence intervals (CI), 1.04-1.12), the number of organ failures (OR, 2.03; CI, 1.50-2.67) and the presence of a high risk diagnosis (OR, 3.50; CI 1.93-6.37). The ICU mortality was also associated with the APACHE II(M) score (OR, 1.07; CI, 1.03-1.11), the number of organ failures (OR, 1.63; CI, 1.26-2.09) and the presence of a high risk diagnosis (OR, 3.22; CI 1.81-5.76).


CONCLUSIONS
We did not find a statistically significant association between age and mortality. We recommend that age should not be used as a criterion for admission.