Observational studyCritical care (London, England)2026
Decreasing admissions in older and increasing mortality in younger patients: a nationwide observational study of all German ICU cases 2011-2022.
Observational study in Critical care (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDemographic aging is expected to substantially affect intensive care medicine, with a growing proportion of elderly patients and increasing clinical complexity, while resources remain limited. It is therefore critical for clinicians and health systems to understand, how intensive care unit (ICU) admissions, outcomes, and treatment intensity across patients of differing age have evolved in recent years. Longitudinal data on these parameters are scarce on the population level.
methodsWe conducted a retrospective population-based analysis of all German inpatient cases from 2011-2022. Hospitalizations with ICU treatment ≥ 24 h were included. Temporal trends in ICU admissions, in-hospital mortality, ICU-related deaths, and use of organ replacement therapies (ORT) were analyzed and stratified by age groups. ORTs comprised mechanical ventilation, renal replacement therapy, and extracorporeal membrane oxygenation.
resultsOverall, 8.4 million ICU admissions were analyzed. During the observation period, ICU admissions showed an overall decline of 12.6%, driven by reductions in patients aged 65-79 years (- 18.1%) and ≥ 80 years (- 24%), while remaining stable in younger patients. Despite fewer admissions, ICU-related mortality showed an overall increase from 14.4% to 18.9%, mainly in patients < 80 years. Overall, in-hospital deaths declined across all age groups, but the proportion of ICU-related deaths rose among patients < 80 years. ORT use increased across all age groups and was associated with persistently high mortality, particularly with combined ORTs (up to 79%). Patients aged 65-79 years received combined ORTs most frequently. Patients ≥ 80 years had the highest mortality.
conclusionsICU utilization and outcomes in Germany have shifted markedly over the past decade. Declining admissions among older patients, increasing ICU-related mortality in younger patients, and rising treatment intensity underscore age-specific differences in critical care delivery and outcomes, with important implications for ICU admission practices, treatment decisions and future resource planning.
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