Abstract
IntroductionThe Dutch population is ageing and it is unknown how this is affecting trends in the percentage of hospital and intensive care unit (ICU) admissions attributable to patients aged 80 years or older, the very elderly.MethodsWe present data on the percentage of the very elderly in the general population and the percentage of hospital admissions attributable to the very elderly. We subsequently performed a longitudinal cross-sectional study on ICU admissions from hospitals participating in the National Intensive Care Evaluation registry for the period 2005 to 2014. We modeled the percentage of adult ICU admissions and treatment days attributable to the very elderly separately for ICU admissions following cardiac surgery and other reasons.ResultsThe percentage of Dutch adults aged 80 years and older, increased from 4.5 % in 2005 to 5.4 % in 2014 (p-value < 0.0001) and with this ageing of the population, the percentage of hospital admissions attributable to very elderly increased from 9.0 % in 2005 to 10.6 % in 2014 (p-value < 0.0001). The percentage of ICU admissions following cardiac surgery attributable to the very elderly increased from 6.7 % in 2005 to 11.0 % in 2014 in nine hospitals (p-value < 0.0001), while the percentage of treatment days attributable to this group rose from 8.6 % in 2005 to 11.7 % in 2014 (p-value = 0.0157). In contrast, the percentage of very elderly patients admitted to the ICU for other reasons than following cardiac surgery remained stable at 13.8 % between 2005 and 2014 in 33 hospitals (p-value = 0.1315). The number of treatment days attributable to the very elderly rose from 11,810 in 2005 to 15,234 in 2014 (p-value = 0.0002), but the percentage of ICU treatment days attributable to this group remained stable at 12.0 % (p-value = 0.1429).ConclusionsAs in many European countries the Dutch population is ageing and the percentage of hospital admissions attributable to the very elderly rose between 2005 and 2014. However, the percentage of ICU admissions and treatment days attributable to very elderly remained stable. The percentage of ICU admissions following cardiac surgery attributable to this group increased between 2005 and 2014.Electronic supplementary materialThe online version of this article (doi:10.1186/s13054-015-1061-z) contains supplementary material, which is available to authorized users.
Highlights
The Dutch population is ageing and it is unknown how this is affecting trends in the percentage of hospital and intensive care unit (ICU) admissions attributable to patients aged 80 years or older, the very elderly
Older patients comprise a minority of the population, they are responsible for a substantial proportion of hospitalizations and healthcare costs, including intensive care unit (ICU) treatment days [5,6,7]
We examine trends in the acute physiology and chronic health evaluation II (APACHE II) [30] and simplified acute physiology score II (SAPS II) [31] predicted probabilities of mortality and length of ICU stay for the very elderly and the proportion of very elderly patients with chronic renal, cardiovascular or immunological insufficiency, a malignancy and who were admitted to the ICU for medical reasons
Summary
The Dutch population is ageing and it is unknown how this is affecting trends in the percentage of hospital and intensive care unit (ICU) admissions attributable to patients aged 80 years or older, the very elderly. The percentage of people in the Netherlands aged 80 years or older patients comprise a minority of the population, they are responsible for a substantial proportion of hospitalizations and healthcare costs, including intensive care unit (ICU) treatment days [5,6,7]. In Denmark, this percentage increased marginally from 11.7 % in 2005 to 13.8 % in 2011 [22] It is unclear how the results of these studies relate to the situation in the Netherlands
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