The following is a summary of “Long-term conditional mortality rate in older ICU patients compared to the general population,” published in the November 2024 issue of Critical Care by Dannewitz et al. 

Researchers conducted a retrospective study to examine the preexisting comorbidities that influenced long-term survival in older adults admitted to the ICU.  

They analyzed mortality following the first ICU admission in individuals aged 55 years or older using Swedish Intensive Care Registry data. Age- and sex-matched comparisons were made with individuals from the general population, with a 1-year post-admission landmark and Cox regression was performed to compare adjustments for age, sex, and baseline comorbidities.   

The results showed that the 7-year study included 1,40,008 patients, 23% of whom were 80 or older. Patients surviving the first year had an increased risk compared to the general population, but this difference was primarily attenuated after adjusting for baseline comorbidities (HR, 1.03; 95% CI 1.02-1.04). Excluding cardio-thoracic ICU admissions, the increased risk remained slightly elevated (adjusted HR, 1.15; 95% CI 1.13-1.16). Additionally, the subgroup aged ≥75 years surviving the first year returned to a mortality rate comparable to the general population (HR, 0.98; 95% CI 0.96-0.99). Stratified by admission diagnosis, an increased mortality rate persisted beyond the first year for acute-on-chronic respiratory failure (adjusted HR, 1.47; 95% CI 1.36-1.58) but not for other respiratory causes (adjusted HR, 1.03; 95% CI 0.99-1.07) or admission for septic shock (adjusted HR, 1.04; 95% CI 0.95-1.13). There was no substantial increased mortality rate beyond the first year for other admission diagnoses.  

Investigators concluded that OAs who survived ICU experienced a return to near-general population mortality rates after the first year, with variations observed based on the initial ICU admission diagnosis. 

Source: ccforum.biomedcentral.com/articles/10.1186/s13054-024-05147-z