Clinical characteristics and cost of hospital stay of octogenarians and nonagenarians in intensive care nephrology unit

Int Urol Nephrol. 2021 Jan;53(1):147-153. doi: 10.1007/s11255-020-02647-z. Epub 2020 Sep 19.

Abstract

Purpose: As the population gets older, the elderly and very elderly patients are increasingly been treated in nephrology intensive care units (ICU). In this study we evaluated the characteristics and outcomes of the octogenarians (80-89 years old), nonagenarians (≥ 90 years old) and compared them with elderly (65-79 years old) patients treated in nephrology ICU.

Methods: Eighteen nonagenarians, 70 octogenarians and 88 elderly patients were included in the study. Indication for hospitalization, presence of comorbid diseases, and requirement for acute dialysis treatment were investigated. Need for mechanical ventilation, vasopressors, central venous catheterization, urinary catheterization, anticoagulation, and transfusion of blood products were evaluated. Mortality rate and hospital cost were calculated. Data about survival at 1 month after discharge was collected.

Results: Causes of hospitalization, need for dialysis treatment, mechanical ventilation, vasopressors, central venous catheterization, urinary catheterization, anticoagulation, and transfusion of blood products were not different between age groups. Diabetes mellitus and malignancy were more frequent in elderly, whereas dementia/Alzheimer's disease was more common in nonagenarians. Although, mortality in ICU was increased as the age increased, it was statistically insignificant. However, 1 month mortality rate after discharge from hospital was increased especially in nonagenarians. In nonagenarians infection, whereas in octogenarians need for dialysis treatment, were related with mortality. Length of intensive care stay and hospital cost did not differ between age groups.

Conclusion: Length of nephrology intensive care stay, mortality rate and hospital cost did not differ for very elderly age groups, but mortality risk was higher for nonagenarians after discharge from hospital.

Keywords: Intensive care nephrology unit; Mortality; Nonagenarians; Octogenarians.

Publication types

  • Comparative Study

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Female
  • Hospital Costs*
  • Humans
  • Intensive Care Units / economics*
  • Length of Stay / economics*
  • Male
  • Nephrology
  • Retrospective Studies
  • Urologic Diseases / economics*
  • Urologic Diseases / therapy*