Pneumonia-Related Mortality in the Elderly: A Focus on ICU Outcomes and Risk Factors

Objectives: Individuals aged 80 and above, classified as the oldest old, are a growing population frequently requiring intensive care unit (ICU) admissions due to pneumonia. The disease in this group is complicated by comorbidities, immune dysfunction, and antibiotic-resistant infections. This study aimed to identify factors influencing mortality in elderly ICU patients. Materials and Methods: This retrospective study included 135 patients aged 80+ diagnosed with pneumonia in the ICU. Demographic data, clinical findings, laboratory results, and outcomes were analyzed. APACHE-II and SOFA scores were calculated upon admission. One-month in-hospital mortality was the primary endpoint, and predictors of mortality were examined. Results: The average age was 86.87, with a 39.2% mortality rate. APACHE II and SOFA scores were strong predictors of mortality. Factors associated with increased mortality included hemodialysis(p<0.001), invasive mechanical ventilation(p<0.001), low albumin(p=0.006), high procalcitonin(p=0.003), Neutrophil Percentage/Albumin Ratio (NPAR)(p<0.001), urea (p<0.001), and creatinine(p=0.010). Chronic Obstructive Pulmonary Disease (COPD) emerged as an independent risk factor. Conclusions: Mortality in elderly pneumonia patients is multifactorial. APACHE II, SOFA scores, and markers such as NPAR and COPD significantly affect outcomes. These findings underscore the importance of strategies to prevent organ dysfunction, monitor nutritional status, and manage infections in this vulnerable population.