ArticleAnnals of intensive care2025
Prognosis of Nonagenarian ICU Patients A Bayesian analysis of prospective European studies.
Article in Annals of intensive care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- End-of-life decision-making in very old critically ill patients.European geriatric medicine · 2026Review
- [Ethically challenging determination of treatment goals in the intensive care unit: reasons, frequency and possible solutions].Die Anaesthesiologie · 2026Review
- Impact of treatment goals on outcomes in critically ill nonagenarians: a retrospective observational study.BMC geriatrics · 2026Observational
- Long-term frailty trajectory in older ICU survivors requiring mechanical ventilation: a prospective cohort study in Norway.Annals of intensive care · 2026Article
- Characterizing ICU-like profiles of very old patients hospitalized in medical intermediate care units in France: A clustering analysis of a nationwide population-based study.Annals of intensive care · 2026Article
- Characteristics and outcomes of diabetes emergencies in nonagenarians admitted to ICU: a binational retrospective cohort study.Frontiers in clinical diabetes and healthcare · 2026Article
- Impact of frailty on in-hospital outcomes in nonagenarian ICU patients: a binational multicenter analysis of 8,220 cases.Critical care (London, England) · 2025Article
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Authors and funding
21 authors.
Funding
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Abstract
backgroundAs the population ages, the number of very elderly patients (≥ 90 years, nonagenarians) admitted to intensive care units (ICUs) is increasing. This trend raises concerns about the appropriateness of ICU care for this age group, especially due to the uncertainty surrounding their prognosis. Some studies suggest that elderly ICU patients have outcomes similar to slightly younger patients, but skepticism remains due to clinical judgment, cultural attitudes, and resource allocation concerns.
methodsWe reassessed the 30-day mortality risk of nonagenarians admitted to ICUs using data from the VIP1, VIP2, and COVIP registries. Bayesian statistical methods, including Markov Chain Monte Carlo (MCMC) simulations, were used to estimate the relative risk (RR) of mortality for nonagenarians compared to octogenarians (80-89 years). Various prior assumptions (non-informative, pessimistic, and skeptical) were incorporated. The analysis adjusted for key variables such as SOFA score, frailty, and treatment limitations.
resultsA total of 8,408 patients were included, consisting of 807 nonagenarians and 7,601 octogenarians. The 30-day mortality rate was 45% for nonagenarians and 42% for octogenarians (p = 0.12). Bayesian analysis revealed a high probability (81.1-97.9%) that nonagenarians face a higher 30-day mortality risk. However, the probability of a clinically significantly increase in mortality (RR > 1.1) was moderate (28.9-34.7%), and the probability of a substantial increase (RR > 1.2) was very low (0.03-1.9%).
conclusionNonagenarians in the ICU have a slightly higher 30-day mortality risk compared to octogenarians, but the increase is unlikely to exceed clinically meaningful thresholds. Bayesian methods offer more refined mortality risk assessment, suggesting that ICU admission decisions should be based on individualized factors, not just age.
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Registered trials
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