Outcomes of very elderly trauma ICU patients. Results from the Spanish trauma ICU registry

Objective: To analyze outcomes and factors related to mortality among very elderly trauma patients admitted to intensive care units (ICUs) participating in the Spanish trauma ICU registry. Design: A multicenter nationwide registry. Retrospective analysis. November 2012-May 2017. Setting: Participating ICUs. Patients: Trauma patients aged >= 80 years. Interventions: None. Main variables of interest: The outcomes and influence of limitation of life sustaining therapy (LLST) were analyzed. Comparisons were established using the Wilcoxon test, Chi-squared test or Fisher's exact test as appropriate. Multiple logistic regression analysis was performed to analyze variables related to mortality. A p-value <0.05 was considered statistically significant. Results: The mean patient age was 83.4 +/- 3.3 years; 281 males (60.4%). Low-energy falls were the mechanisms of injury in 256 patients (55.1%). The mean ISS was 20.5 +/- 11.1, with a mean ICU stay of 7.45 +/- 9.9 days. The probability of survival based on the TRISS methodology was 69.8 +/- 29.7%. The ICU mortality rate was 15.5%, with an in-hospital mortality rate of 19.2%. The main cause of mortality was intracranial hypertension (42.7%). The ISS, the need for first- and second-tier measures to control intracranial pressure, and being admitted to the ICU for organ donation were independent mortality predictors. LLST was applied in 128 patients (27.9%). Patients who received LLST were older, with more severe trauma, and with more severe brain injury. Conclusions: Very elderly trauma ICU patients presented mortality rates lower than predicted on the basis of the severity of injury. (C) 2019 Elsevier Espana, S.L.U. y SEMICYUC. All rights reserved.