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Comment & Response
March 13, 2018

ICU Admission and Mortality Among Elderly Adults—Reply

Author Affiliations
  • 1AP-HP, Hôpital Saint-Antoine, Service de Réanimation Médicale, Paris, France
  • 2AP-HP, Hôpital Saint-Antoine, Paris, France
JAMA. 2018;319(10):1047-1048. doi:10.1001/jama.2017.21680

In Reply Dr Andre and colleagues ask why patients with active cancer were excluded from the Intensive Care for Elderly–CUB-Réa 2 (ICE-CUB 2) trial focusing on acutely ill elderly patients presenting to the emergency department. They emphasize that the short-term prognosis of these patients is comparable with that of patients free of cancer and that new therapies, such as targeted or immunotherapies, may improve prognosis in the future. They rely on a single-center study documenting that ICU mortality and 90-day mortality of ICU patients older than 65 years with solid tumors were 33.6% and 51.9%, respectively.1 In this study, performance status was not associated with 90-day mortality, although cumulative evidence suggests that mid-term and long-term mortality in elderly patients is mainly influenced by underlying conditions, as documented recently with the clinical frailty score.2