Intensive care unit use and mortality in the elderly

OBJECTIVE: To examine utilization and outcomes of intensive care unit (ICU) use for the elderly in the United States. DESIGN: We used 1992 data from the Health Care Financing Administration to examine ICU utilization and mortality by age and admission reason for hospi talizations of elderly Medicare beneficiaries. MAIN RESULTS: Use of the ICU was least likely for the oldest elderly overal l (85+ years, 21.1% of admissions involved ICU; 75-84 years, 27.9%: 65-74 y ears, 29.7%), but more likely during surgical admissions, Eighty-three perc ent of the Medicare patients who received intensive care survived at least 90 days. Of the oldest elderly, 74% survived. Even among the 10% most expen sive ICU hospitalizations, 77% of all patients and 62% of those 85 yeats an d older survived at least 90 days. CONCLUSIONS: The Likelihood of ICU use among these elderly decreased with a ge, especially among those 85 years or older, Diagnostic mix importantly in fluenced ICU use by age. The great majority of the elderly, including those 85 years and older and those receiving the most expensive ICU care, surviv ed at least 90 days.