Assessment of geriatric patients at the internal medicine intensive care unit (IMICU)

Background: The aim of this study was to evaluate the general characteristics of geriatric patients hospitalized at the internal medicine intensive care unit (IMICU). Methods: All patients aged above 65 years and admitted to the intensive care unit of the internal medicine department at Ege University Hospital October 2010 to February 2011 were included in the study. Files of the patients were accessed retrospectively and the following information was recorded: age, gender, main cause of intensive care admission, number of chronic diseases, laboratory results, drug use and other therapeutic procedures, length of stay, outcomes in terms of survival and mortality. Secondary outcomes were defined to compare patients admitted to the intensive care unit from the emergency ward with those transferred from the internal medicine wards. Results: The total number of patients admitted to the internal medicine intensive care unit during the study period was 357, of whom 171(47.99%) were aged above 65 years, a mean age of 74 +/- 6.6 years without any statistically significant difference between gender (P = 0.859). Days of hospitalization at the intensive care were 15.7 +/- 4.8, in patient mortality was found to be 17.7%, The mean number of chronic diseases per patient was 2.2 +/- 1.3. and the most frequent chronic diseases were arterial hypertension 57%. The most frequent pathology of the patients was found to be renal dysfunction 38.6% (n = 66), followed by anaemia 38.0% (n = 65) and liver dysfunction 11.7% (n = 20). The ratio of haemodialysis (HD) was found as 11.7%. When the patients were assessed in terms of invasive interventions by grouping them into those admitted from the emergency unit and those transferring from the internal medicine departments, it was seen that foley, intravenous catheterization, nasogastric tube insertion and HD were significantly higher for the patients admitted from the emergency unit. Mortality rate was found to be significantly higher for same group (44% versus 17, P < 0.001). Conclusion: The proportion of elderly in the intensive care unit is increasing. In the present study renal dysfunction is the most common organ failure. Infection seems to be one of the common problems in IMICU. Organ failure and invasive intervention needs are high in elderly patient admitted from the emergency ward to intensive care. (c) 2012 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.