A critical decision point: Short- and long-term outcomes of older surgical patients admitted to a Queensland intensive care unit

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Zhang, Alice T
Tan, Samuel X
Pillay, Praga S
Stewart, David
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2022
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Abstract

OBJECTIVES: Critical care admission is a pivotal juncture for older patients undergoing surgery. We aimed to identify the in-hospital and postdischarge outcomes of older postsurgical patients (≥65 years) admitted to the intensive care unit (ICU). METHODS: We collected clinical, morbidity and survival data on all patients aged ≥65 years postsurgically admitted to a tertiary metropolitan ICU between 2014 and 2019. RESULTS: Within this older cohort (n = 370), the oldest patients (≥85 years) had the highest 1-year mortality (RR: 4.00; P < 0.001). Major surgery (RR: 5.67; P < 0.001), emergency surgery (RR: 2.89; P < 0.001) and APACHE III score ≥50 (RR: 2.63; P < 0.001) were associated with reduced 1-year survival. CONCLUSIONS: APACHE III score and surgery subtype are strong predictors of post-ICU mortality and may be useful to preoperatively stratify whether surgery and subsequent ICU admission are in patients' best interests. These data may also inform prospective discussions regarding end-of-life care and advanced care planning.

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Australasian Journal on Ageing

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41

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1

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Aged health care

Surgery

Science & Technology

Life Sciences & Biomedicine

Geriatrics & Gerontology

Gerontology

aged

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Zhang, AT; Tan, SX; Pillay, PS; Stewart, D, A critical decision point: Short- and long-term outcomes of older surgical patients admitted to a Queensland intensive care unit, Australasian Journal on Ageing, 2021, 41 (1), pp. E32-E40

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