7th April 2017, Volume 130 Number 1453

Owen Keet, Stephanie Chisholm, Jennifer Goodson, Troy Browne

Admitting very elderly patients to intensive care units (ICU) is a controversial issue. With current demographic projections, increasing life expectancy and increasing complexity of interventions, we will see many more…

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Summary

The decision whether to admit and treat the very elderly patient with septic shock in ICU is a complex decision. Although age in itself is not a reason to deny a patient ICU admission, it is taken into account in context of the burden of chronic and acute disease. The patient selection and subsequent treatment at Tauranga Hospital, a secondary level New Zealand hospital, produced results that saw most of the patients during a five-year period, including those >85 years, being discharged alive from hospital. This study suggests that with carefully considered selection, elderly patients greater than 85 years may have an acceptable long-term outcome following an episode of septic shock.

Abstract

Aim

Admitting very elderly, critically ill patients to ICU is controversial. We compared our mortality data in a subgroup of elderly patients to internationally published outcomes.

Method

Tauranga Hospital ICU retrospectively investigated their mortality outcomes for patients with septic shock. The ANZICS adult database (AORTIC), Tauranga Hospital computer records and medical records were used to identify the study cohort and provide information on demographics, admission times and shock types between January 2009 and December 2014. Patients were divided into groups; not old (<74 years), old (75–84 years) and very old (>85 years) to compare survival statistics at ICU discharge, hospital discharge, 28 days, six months and 12 months.

Results

Patients in the >85 year group at Tauranga ICU had a 38.5% survival.

Conclusion

With careful selection, elderly patients with septic shock may have an acceptable outcome.

Author Information

Owen Keet, Intensive Care, Tauranga Hospital, Tauranga; Stephanie Chisholm, Medical School, Auckland University, Auckland; Jennifer Goodson, Intensive Care, Bay of Plenty District Health Board, Bay of Plenty; Troy Browne, Intensive Care, Tauranga Hospital, Tauranga.

Correspondence

Dr Owen Keet, Intensive Care, Tauranga Hospital, Cameron Road, Tauranga 3143.

Correspondence Email

owenkeet@bopdhb.govt.nz

Competing Interests

Nil.

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