Sunday, 16 November 2014

PODCAST : The Ageing Casemix of Intensive Care

Over 50% of patients admitted to Australian Intensive Care units are over 65 years old.

Its a common discussion point in ICU tea rooms around the western world.  The population of patients we are collectively caring for seem to be getting older and older, and many are questioning the validity of this.  Surely, the older the patient gets the worse their outcomes...

Well, its not as clear as that.

I recently had the opportunity to chat to Dr Graeme Duke, an Intensivist in Melbourne, Australia, the lead author on a paper examining the outcomes for older patients in Intensive Care in Victoria.  Graeme's group conducted a retrospective analysis of over 100 000 patients aged over 80 years old.  Interestingly, despite an ongoing increase in admissions of these patients to acute care facilities, their admission to ICU actually reduced.  Furthermore, their adjusted mortality appears to decrease, without an increase in prolonged hospital admission or discharge to high level nursing care, suggesting that "picking a better octagenarian" is not the reason for this improvement.  Age, they concluded, does not appear to influence outcomes as much as the other prognostic factors at play.

In this interview, Graeme explores some of the details of the paper and suggests some reasons that might explain them.


If you'd like to have a read of this article, the reference is below, or click here.

Outcomes for Older Patients Receiving Intensive Care in Victoria.  Duke G, Barker A, Knott C, Santa Maria J.  Med J Aust 2014; 200:323-6