TY - JOUR T1 - Mortality in Critically Ill Elderly Individuals Receiving Mechanical Ventilation JF - Respiratory Care SP - 473 LP - 483 DO - 10.4187/respcare.06586 VL - 64 IS - 4 AU - Roberto Santa Cruz AU - Fernando Villarejo AU - Alvaro Figueroa AU - Marcela Cortés-Jofré AU - Juan Gagliardi AU - Marcelo Navarrete Y1 - 2019/04/01 UR - http://rc.rcjournal.com/content/64/4/473.abstract N2 - BACKGROUND: Previous studies that evaluated mortality in elderly subjects who received mechanical ventilation had conflicting results. The aim of this systematic review was to evaluate the effects of age on mortality.METHODS: A number of medical literature databases and the references listed (from 1974 to May 2015) were searched for studies that compared 2 different age groups. The primary outcome was mortality in subjects ages ≥ 65 y. The severity scores, ICU and hospital lengths of stay, and the presence of ventilator-associated pneumonia were secondary outcomes. Finally, mortality in the subjects with ARDS and of cutoff ages 70 and 80 y was assessed by subgroup analysis. Evidence quality was assessed by the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) criteria score.RESULTS: Of the 5,182 articles identified, 21 were included. Subjects ages ≥ 65 y had higher mortalities (odds ratio [OR] 1.80, 95% CI 1.56–2.08; I2 = 71%). APACHE (Acute Physiology and Chronic Health Evaluation) II revealed intergroup differences (mean difference 3.07, 95% CI 2.52–3.61; I2 = 0%), whereas neither the ICU nor hospital length of stay (mean difference 1.27, 95% CI −0.82 to 3.36, I2 = 82%, and mean difference 1.29, 95% CI −0.71 to 3.29, I2 = 0%, respectively) nor the groups in the 2 studies that assessed ventilator-associated pneumonia exhibited any difference. Subgroup analysis revealed a higher mortality in the older subjects, in the subjects with ARDS (OR 1.76, 95% CI 1.30–2.36; I2 = 0%) and in the subjects ages 70 and 80 y (OR 1.78, 95% CI 1.51–2.10, I2 = 71%; and OR 1.96, 95% CI 1.81–2.13, I2 = 0%, respectively). The quality of associated evidence was low or very low.CONCLUSIONS: Although low-quality evidence was available, we conclude that age is associated with a greater mortality in critical subjects who were receiving mechanical ventilation. ER -