Turkish Journal of
GERIATRICS

Taksim Training and Research Hospital, Department of Anesthesiology and Reanimation, İstanbul, Türkiye DOI : 10.29400/tjgeri.2026.489 Introduction: As the number of older patients admitted to intensive care units (ICUs) increases, distinguishing predictors of mortality from determinants of recovery is increasingly relevant. The primary aim of this study was to identify predictors of ICU mortality, and the secondary aim was to evaluate factors associated with ICU length of stay among survivors. Materials and Method: This retrospective cohort study included 2,029 patients aged ?65 years admitted to the ICUs of a tertiary hospital from January 2020 to December 2025. ICU mortality was assessed using multivariable Cox regression, and ICU length of stay among survivors was analyzed using multivariable linear regression. Age, sex, ICU level, APACHE II score, Charlson Comorbidity Index, coronavirus disease 2019 (COVID-19) status, and admission diagnosis were included as covariates. Results: The median age was 78 years (quartiles 1?3, 72?86), and ICU mortality was 37.3%. Older age (hazard ratio [HR]: 1.015 per year; p = 0.002), male sex (HR: 1.160; p = 0.049), a level 3 ICU admission (HR: 1.579; p = 0.015), a higher APACHE II score (HR: 1.066 per point; p < 0.001), and sepsis as the primary admission diagnosis (HR: 2.307; p < 0.001) were independently associated with mortality. Among survivors, a higher Charlson Comorbidity Index (p < 0.001), COVID-19 positivity (p < 0.001), and admission diagnosis (overall p < 0.001) were independently associated with a prolonged ICU stay. Conclusion: Among critically ill older adults, short-term ICU survival was primarily associated with acute illness severity, whereas a prolonged ICU stay among survivors was more strongly associated with pre-existing comorbidity burden. Keywords : Intensive Care Units; Aged; Mortality; Length of Stay; Severity of Illness Index; Comorbidity