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A6850 - ICU Cost and Mortality Outcomes by Decade of Life
Author Block: K. Dave1, S. Dhar2, E. Cassity1, A. Kelly1, P. E. Morris3; 1Pulmonary Critical Care medicine, University of Kentucky, Lexington, KY, United States, 2Pulmonary Critical Care Allergy and Immunology, Lexington, KY, United States, 3University of Kentucky, Lexington, KY, United States.
Introduction - Despite longer ICU days and higher mortality per decade of life, data contrasting hospital care costs by day and by decade, may help us examine whether differences in practice exists for different aged ICU patients.
Method - We performed a retrospective examination of a single center administrative database a tertiary university hospital. We gathered data on Medical ICU admissions from FY 2014-2017. ICU Admisisons were examined for age groups (18-30 years, 31-40, 41-50, to 100). Age, BMI, Charlson index, SOFA score, case mix index, ICU length of stay, ventilator days, ventilator-free days, shock, continuous renal replacement therapy (CRRT) , inpatient mortality and discharge destination for hospital survivors. Average direct costs and average direct costs per day were calculated.
Results - Of the 8,174 patients, in-patient mortality was the lowest in the 18-30 years group (11.1%) and highest in 81-90 years group (33.3%). Medically underserved home county did not act as an independent predictor of mortality. Significantly lower percent of patients beyond age 71 years were discharged home (6.3% among 91+ years of age compared to 61.4% in 18-30 years of age). Significantly higher number of patients in age groups 71 and beyond were discharged to home health, rehab facility, nursing facility, LTAC or hospice. Interestingly however, average direct daily costs was not significantly different among different age groups.
Conclusion - While the average daily costs for ICU stay remained similar across different age groups, increasingly fewer patients in age group 70 years and above were discharged home. These data may help us understand better our approach to older ICU patients in regards to utilization of resources during an ICU stay.