Hospital mortality in postoperative critically ill patients older than 80 years. Can we predict it at an early stage

Abstract Objectives To determine the incidence of in-hospital mortality throughout the post-surgical period of patients aged 80 or over who were admitted to the post-surgical critical care unit, as well as to assess the predictive capacity of those variables existing in the first 48 h on the in-hospital mortality. Material and methods An observational retrospective cohort study conducted on postsurgical patients up to 80 years old who were admitted to the unit between June 2011 and December 2013. Univariate and multivariate binary logistic regression was used to determine the association between mortality and the independent variables. Results Of the 186 patients included, 9 (4.8%) died in the critical care unit, and 22 (11.8%) died in wards during hospital admission, giving a hospital mortality of 31 (16.7%). Among the 78 patients (42%) that underwent acute surgery, and the 108 who underwent elective surgery, there was a mortality rate of 19 (10.2%) and 12 (6.5%), respectively. As regards the variables analysed during the first 48 h of admission that showed to be hospital mortality risk factor were the need for mechanical ventilation over 48 h, with an OR: 7.146 (95% CI: 1.563–32.664, p  = .011) and the degree of the severity score on the APACHE II scale in the first 24 h, with an OR: 1.102 (95% CI: 1.005–1.208, p  = .039). Conclusion The incidence of hospital mortality in very old patients found in our study is comparable to that reported by other authors. Patients who need mechanical ventilation over 48 h, and with higher scores in the APACHE II scale could be at a higher risk of in-hospital mortality.