@article {Wernly814, author = {Bernhard Wernly and Raphael Romano Bruno and Fernando Frutos-Vivar and Oscar Pe{\~n}uelas and Richard Rezar and Konstantinos Raymondos and Alfonso Muriel and Bin Du and Arnaud W Thille and Fernando R{\'\i}os and Marco Gonz{\'a}lez and Lorenzo del-Sorbo and Maria del Carmen Mar{\'\i}n and Bruno Valle Pinheiro and Marco Antonio Soares and Nicolas Nin and Salvatore M Maggiore and Andrew Bersten and Malte Kelm and Pravin Amin and Nahit Cakar and Gee Young Suh and Fekri Abroug and Manuel Jibaja and Dimitros Matamis and Amine Ali Zeggwagh and Yuda Sutherasan and Bertrand Guidet and Dylan W De Lange and Michael Beil and Sigal Svri and Vernon van Heerden and Hans Flaatten and Antonio Anzueto and Venet Osmani and Andr{\'e}s Esteban and Christian Jung}, title = {Propensity-Adjusted Comparison of Mortality of Elderly Versus Very Elderly Ventilated Patients}, volume = {66}, number = {5}, pages = {814--821}, year = {2021}, doi = {10.4187/respcare.08547}, publisher = {Respiratory Care}, abstract = {BACKGROUND: The growing proportion of elderly intensive care patients constitutes a public health challenge. The benefit of critical care in these patients remains unclear. We compared outcomes in elderly versus very elderly subjects receiving mechanical ventilation.METHODS: In total, 5,557 mechanically ventilated subjects were included in our post hoc retrospective analysis, a subgroup of the VENTILA study. We divided the cohort into 2 subgroups on the basis of age: very elderly subjects (age >= 80 y; n = 1,430), and elderly subjects (age 65{\textendash}79 y; n = 4,127). A propensity score on being very elderly was calculated. Evaluation of associations with 28-d mortality was done with logistic regression analysis.RESULTS: Very elderly subjects were clinically sicker as expressed by higher SAPS II scores (53 {\textpm} 18 vs 50 {\textpm} 18, P \< .001), and their rates of plateau pressure \< 30 cm H2O were higher, whereas other parameters did not differ. The 28-d mortality was higher in very elderly subjects (42\% vs 34\%, P \< .001) and remained unchanged after propensity score adjustment (adjusted odds ratio 1.31 [95\% CI 1.16{\textendash}1.49], P \< .001).CONCLUSIONS: Age was an independent and unchangeable risk factor for death in mechanically ventilated subjects. However, survival rates of very elderly subjects were \> 50\%. Denial of critical care based solely on age is not justified. (ClinicalTrials.gov registration NCT02731898.)}, issn = {0020-1324}, URL = {https://rc.rcjournal.com/content/66/5/814}, eprint = {https://rc.rcjournal.com/content/66/5/814.full.pdf}, journal = {Respiratory Care} }