Evaluation of the Effect of Clinical Characteristics and Intensive Care Treatment Methods on the Mortality of Covid-19 Patients Aged 80 Years and Older

Sibel Oba; Mustafa Altınay; Aysel Salkaya; Hacer Şebnem Türk

Disclosures

BMC Anesthesiol. 2021;21(291) 

In This Article

Background

During the Coronavirus disease 2019 (Covid-19) pandemic, older adults have been the most vulnerable age group. Data from international intensive care experience indicate that patients older than 65 years of age are more likely to require hospitalization, admission to intensive care and had a higher mortality rate.[1,2] However, few reports have investigated the clinical course and characteristics of Covid-19 among the elderly patients aged 80 years and older.[3–5] Moreover these reports were mostly about the mortality and morbidity of 80 years and older Covid-19 patients treated in local hospitals without intensive care unit (ICU) or in nursing homes.[6]

Despite the high number of publications on the topic of Covid-19 pandemic, there are various issues about the treatment of the disease yet to be resolved. Among such issues, is the prognosis of Covid-19 patients older than 80 years with respiratory failure who require ICU treatments. There is a limited number of studies about the intensive care treatments of Covid-19 patients older than 80 years. The results of these studies are controversial: some of the researchers have concluded that the mortality rate among patients 80 years and older who required advanced therapies in intensive care is very high and that invasive intensive care treatment fails to save the lives of the vast majority of elderly patients with respiratory insufficiencies.[4] On the other hand, certain previous studies have revealed that chronological age alone should never be the sole criterion for intensive care treatment indication and there are some older patients who may receive greater benefit from ICU care than younger patients.[5]

The Covid-19 pandemic is pressuring health care systems. Many countries have adopted a decision guide about the use of medical resources such as ventilators or dialysis machines in order to avoid the collapse of ICUs and to maximize the health care benefits.[7] However, during this period of Covid-19 pandemic there has been no triage or selection process applied by Turkish authorities and every Covid-19 patient in need of intensive care treatment was admitted to public hospitals. Consequently, a significant data about Covid-19 patients aged 80 years and older who received intensive care treatment was collected. In this retrospective study, the efficacy of the ICU treatments on the mortality of Covid-19 patients aged 80 years and older is investigated based on their clinical features, laboratory findings and the intensive care treatments methods.

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