A critical decision point: Short- and long-term outcomes of older surgical patients admitted to a Queensland intensive care unit

Objectives Critical care admission is a pivotal juncture for older patients undergoing surgery. We aimed to identify the in-hospital and postdischarge outcomes of older postsurgical patients (>= 65 years) admitted to the intensive care unit (ICU). Methods We collected clinical, morbidity and survival data on all patients aged >= 65 years postsurgically admitted to a tertiary metropolitan ICU between 2014 and 2019. Results Within this older cohort (n = 370), the oldest patients (>= 85 years) had the highest 1-year mortality (RR: 4.00; P < 0.001). Major surgery (RR: 5.67; P < 0.001), emergency surgery (RR: 2.89; P < 0.001) and APACHE III score >= 50 (RR: 2.63; P < 0.001) were associated with reduced 1-year survival. Conclusion APACHE III score and surgery subtype are strong predictors of post-ICU mortality and may be useful to preoperatively stratify whether surgery and subsequent ICU admission are in patients' best interests. These data may also inform prospective discussions regarding end-of-life care and advanced care planning.