# Clinical Characteristics and Outcomes in Patients Aged ≥80 Years Treated in the Intensive Care Units of a Large Multispecialty Metropolitan Hospital in Poland

## TL;DR

This study examines the clinical characteristics and outcomes of ICU patients aged 80 and older in a Polish hospital, finding that frailty is a strong predictor of death.

## Contribution

The study identifies Clinical Frailty Scale as a significant independent risk factor for mortality in elderly ICU patients.

## Key findings

- The overall mortality rate was 76.4%, independent of age and sex.
- Frailty, measured by the Clinical Frailty Scale, was a significant predictor of death.
- High mortality rates were observed for patients receiving organ support techniques like mechanical ventilation and renal replacement therapy.

## Abstract

Backgrounds/Objectives: The aging of the population is reflected in the increasing number of elderly patients admitted to intensive care units (ICUs), where assessing prognosis and the potential benefit of intensive care is challenging. The aim of this study was to clinically characterize ICU patients aged ≥80 years in the National Medical Institute of the Ministry of Internal Affairs and Administration in Warsaw, Poland. Methods: We retrospectively analyzed ICU patients admitted between 2018 and 2022, considering comorbidities, prognostic scores, the treatment methods and outcomes. Results: We included 476 patients (median age 84 [range 80–103 years], female 54.4%, median ICU stay 8 days) with a high incidence of various comorbidities. The overall risk of death was very high (76.4%) but was independent of sex and, surprisingly, of age. Advanced frailty was common, as indicated by the Clinical Frailty Scale (CFS) score (median 7, n = 189), which was identified as a significant risk factor for death independent of age, sex, and APACHE score (odds ratio for the 1-point CFS increase: 1.08, 95% CI 1.01–1.15, n = 103), but not of SAPS and SOFA scores. Organ support techniques were frequently used (invasive mechanical ventilation in 90.9%, pharmacological cardiovascular support in 83.2%, and renal replacement therapy in 14.1% of patients), with high associated mortality rates (80%, 79%, and 88%, respectively). Conclusions: Our results confirm the value of the prognostic scales used on admission to the ICU, but also highlight the need for individualized assessment of the expected benefit of ICU treatment in elderly patients, considering specific comorbidities, previous treatment and frailty.