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Original Articles
- Epidemiology
- Characteristics and prognostic factors of very elderly patients admitted to the intensive care unit
- Song-I Lee, Younsuck Koh, Jin Won Huh, Sang-Bum Hong, Chae-Man Lim
- Acute Crit Care. 2022;37(3):372-381. Published online August 4, 2022
- DOI: https://doi.org/10.4266/acc.2022.00066
- 10,017 View
- 299 Download
- 5 Web of Science
- 4 Crossref
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Abstract
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Supplementary Material - Background
Korea is rapidly becoming a super aging society and is facing the increased burden of critical care for the elderly people. Traditionally, far-advanced age has been regarded as a triage criterion for intensive care unit (ICU) admission. We evaluated how the characteristics and prognostic factors of very elderly patients (≥85 years) admitted to the ICU changed over the last decade.
Methods
We retrospectively evaluated the data of patients admitted to the ICU over 11 years (2007–2017). The clinical characteristics and outcomes of the very elderly-patients group were evaluated. Factors associated with mortality were assessed by a cox regression analysis.
Results
Comparing the first half (2007–2012) and the second half (2013–2017) of the study period, the proportion of very elderly group increased from 603/47,657 (1.3%), to 697/37,756 (1.8%) (P<0.001). Among 1,294 very elderly patients, 1,274 patients were analyzed excluding hopeless discharge (n=20). The non-surgical reasons for ICU admission (67.0% vs. 76.1%, P<0.001) and the percentage of patients with co-morbidities (78.3% vs. 82.7%, P=0.048) were increased. Nevertheless, the hospital mortality decreased (21.3% vs. 14.9%, P=0.001). High creatinine levels, use of vasopressors and ventilator weaning failure were associated with in-hospital mortality.
Conclusions
The proportion of very elderly people in the ICU increased over the last decade. The non-surgical causes of ICU admission increased compared with the surgical causes. Despite an increasement in ICU admissions of very elderly patients, in-hospital mortality of very elderly ICU patients decreased. -
Citations
Citations to this article as recorded by
- Clinical characteristics and outcome of very old (≥90 years) critically ill patients with need for intensive care after surgical intervention
Jöran Lücke, Franziska Stallbaum, Rikus Daniels, Pauline Theile, Jakob Izbicki, Anastasios D. Giannou, Stefan Wolter, Anna Duprée, Oliver Mann, Jakob Müller, Stefan Kluge, Matthias Reeh, Kevin Roedl
Frontiers in Medicine.2025;[Epub] CrossRef - Factors Associated with Re-attendance at Emergency Departments Among Older Adults: A Cross-Sectional Analytical Study
Saengdao Janda, Juree Sansuk
INQUIRY: The Journal of Health Care Organization, Provision, and Financing.2025;[Epub] CrossRef - Chronicles of change for the future: The imperative of continued data collection in French ICUs
Takashi Tagami
Anaesthesia Critical Care & Pain Medicine.2023; 42(5): 101294. CrossRef - We need a comprehensive intensive care unit management strategy for older patients
Dong-Ick Shin
Acute and Critical Care.2022; 37(3): 468. CrossRef
- Clinical characteristics and outcome of very old (≥90 years) critically ill patients with need for intensive care after surgical intervention
- Infection
- In-hospital mortality prediction using frailty scale and severity score in elderly patients with severe COVID-19
- Yong Sub Na, Jin Hyoung Kim, Moon Seong Baek, Won-Young Kim, Ae-Rin Baek, Bo young Lee, Gil Myeong Seong, Song-I Lee
- Acute Crit Care. 2022;37(3):303-311. Published online July 5, 2022
- DOI: https://doi.org/10.4266/acc.2022.00017
- 9,293 View
- 250 Download
- 11 Web of Science
- 13 Crossref
-
Abstract
PDF
- Background
Elderly patients with coronavirus disease 2019 (COVID-19) have a high disease severity and mortality. However, the use of the frailty scale and severity score to predict in-hospital mortality in the elderly is not well established. Therefore, in this study, we investigated the use of these scores in COVID-19 cases in the elderly.
Methods
This multicenter retrospective study included severe COVID-19 patients admitted to seven hospitals in Republic of Korea from February 2020 to February 2021. We evaluated patients’ Acute Physiology and Chronic Health Evaluation (APACHE) II score; confusion, urea nitrogen, respiratory rate, blood pressure, 65 years of age and older (CURB-65) score; modified early warning score (MEWS); Sequential Organ Failure Assessment (SOFA) score; clinical frailty scale (CFS) score; and Charlson comorbidity index (CCI). We evaluated the predictive value using receiver operating characteristic (ROC) curve analysis.
Results
The study included 318 elderly patients with severe COVID-19 of whom 237 (74.5%) were survivors and 81 (25.5%) were non-survivors. The non-survivor group was older and had more comorbidities than the survivor group. The CFS, CCI, APACHE II, SOFA, CURB-65, and MEWS scores were higher in the non-survivor group than in the survivor group. When analyzed using the ROC curve, SOFA score showed the best performance in predicting the prognosis of elderly patients (area under the curve=0.766, P<0.001). CFS and SOFA scores were associated with in-hospital mortality in the multivariate analysis.
Conclusions
The SOFA score is an efficient tool for assessing in-hospital mortality in elderly patients with severe COVID-19. -
Citations
Citations to this article as recorded by- Navigating the nexus between senior tourism and healthy aging: a post-neoliberal perspective
Yangyang Jiang, Guohong Yu
Asia Pacific Journal of Marketing and Logistics.2026; 38(1): 148. CrossRef - Respiratory and Pleural Pathogens in Octogenarians Hospitalized with COVID-19: Impact of Secondary Bacterial Pneumonia on Day-5 SOFA and Mortality
Petrinela Daliu, Felix Bratosin, Ovidiu Rosca, Monica Licker, Elena Hogea, Livia Stanga, Camelia Vidita Gurban, Delia Muntean
Microorganisms.2026; 14(1): 164. CrossRef - Quadriceps Muscle Layer Thickness and its association with frailty in critically ill patients: A prospective observational study
Vijay Sundarsingh, R. Manoj Kumar, Manjunath Kulkarni, Debasis Pradhan, Pramela Renisha Rodrigues, Nishanth Baliga, Mamata Prasad, Pooja Yadav, Monish Thomas, Tania Eltrida Pinto
Journal of Critical Care.2025; 85: 154930. CrossRef - Prevalence of New Frailty at Hospital Discharge in Severe COVID-19 Survivors and Its Associated Factors
Jong Hwan Jeong, Manbong Heo, Sunghoon Park, Su Hwan Lee, Onyu Park, Taehwa Kim, Hye Ju Yeo, Jin Ho Jang, Woo Hyun Cho, Jung-Wan Yoo
Tuberculosis and Respiratory Diseases.2025; 88(2): 361. CrossRef - Biological age and clinical frailty scale measured at intensive care unit admission as predictors of hospital mortality among the critically ill in Western Australia: a retrospective cohort study
Nicholas Phillip Anthony, Kwok Ming Ho
Acute and Critical Care.2025; 40(2): 264. CrossRef - Accuracy of Different COVID-19 Severity Scores in ICU Transfer Prediction and Mortality Prediction Among Inpatients at Lebanese American University Medical Center-Rizk Hospital (LAUMC-RH)
Evelyne Towair, Zeina Al Achkar, Romanos Haykal, Ahmad Kassar, Eric Bou Karam, Pascale Salameh, Toufic Chaaban
Cureus.2025;[Epub] CrossRef - Risk factors for progressing to critical illness in patients with hospital-acquired COVID-19
Kyung-Eui Lee, Jinwoo Lee, Sang-Min Lee, Hong Yeul Lee
The Korean Journal of Internal Medicine.2024; 39(3): 477. CrossRef - Omicron, Long-COVID, and the Safety of Elective Surgery for Adults and Children: Joint Guidance from the Therapeutics and Guidelines Committee of the Surgical Infection Society and the Surgery Strategic Clinical Network, Alberta Health Services
Philip S. Barie, Mary E. Brindle, Rachel G. Khadaroo, Tara L. Klassen, Jared M. Huston
Surgical Infections.2023; 24(1): 6. CrossRef - Evaluation of risk scores as predictors of mortality and hospital length of stay for older COVID‐19 patients
Banu Buyukaydin, Tahsin Karaaslan, Omer Uysal
AGING MEDICINE.2023; 6(1): 56. CrossRef - Atypical presentation of COVID-19 in older patients is associated with frailty but not with adverse outcomes
Joy E. van Son, Elisabeth C. P. Kahn, Jessica M. van der Bol, Dennis G. Barten, Laura C. Blomaard, Carmen van Dam, Jacobien Ellerbroek, Steffy W. M. Jansen, Anita Lekx, Carolien M. J. van der Linden, Roy Looman, Huub A. A. M. Maas, Francesco U. S. Mattace
European Geriatric Medicine.2023;[Epub] CrossRef - Neurological Manifestations and Complications of the Central Nervous System as Risk Factors and Predictors of Mortality in Patients Hospitalized with COVID-19: A Cohort Study
Ana Luisa Corona-Nakamura, Martha Judith Arias-Merino, Rayo Morfín-Otero, Guillermo Rodriguez-Zavala, Alfredo León-Gil, Juan Ramsés Camarillo-Escalera, Idarmis Brisseida Reyes-Cortés, María Gisela Valdovinos-Ortega, Erick René Nava-Escobar, Ana María de l
Journal of Clinical Medicine.2023; 12(12): 4065. CrossRef - Modified Early Warning Score: Clinical Deterioration of Mexican Patients Hospitalized with COVID-19 and Chronic Disease
Nicolás Santiago González, María de Lourdes García-Hernández, Patricia Cruz-Bello, Lorena Chaparro-Díaz, María de Lourdes Rico-González, Yolanda Hernández-Ortega
Healthcare.2023; 11(19): 2654. CrossRef - Risk Factors and Predictive Model for Mortality of Hospitalized COVID-19 Elderly Patients from a Tertiary Care Hospital in Thailand
Mallika Chuansangeam, Bunyarat Srithan, Pattharawin Pattharanitima, Pawit Phadungsaksawasdi
Medicines.2023; 10(11): 59. CrossRef
- Navigating the nexus between senior tourism and healthy aging: a post-neoliberal perspective
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