Outcomes of Patients Aged 75 Years or Older Undergoing Endotracheal Intubation: An 11-Year Single-Center Retrospective Study

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Introduction Older adults aged ≥75 years often experience poor outcomes after endotracheal intubation, yet evidence describing survival and successful extubation in this population remains limited. This study evaluated clinical outcomes and factors associated with survival to discharge and successful extubation among elderly patients requiring mechanical ventilation. Methods We conducted a retrospective study at Tokai Central Hospital, Japan, including patients aged ≥75 years who underwent endotracheal intubation between 2014 and 2024. Patients intubated for procedural or perioperative purposes were excluded. Clinical characteristics, comorbidities, residence status, dementia, post-cardiopulmonary resuscitation (CPR) status, albumin level, and underlying disease were extracted from electronic medical records. The primary outcome was survival to discharge, and the secondary outcome was successful extubation. Associations were analyzed using chi-square tests. This study was approved by the Institutional Review Board of Tokai Central Hospital (approval date: August 22, 2025; identifier: 2025081901). Results A total of 147 patients (median age, 82 years) were included. Survival to discharge was 31%, and 27% were successfully extubated. Poorer outcomes were observed in patients aged ≥80 years; those with post-CPR status, dementia, hypoalbuminemia, nursing home residence, or pulmonary disease; and were associated with lower survival and extubation rates. Cardiac disease was associated with higher survival (51%) and extubation rates (42%). The median survival time among patients who died during hospitalization was 11 days. Conclusions Among patients aged ≥75 years undergoing endotracheal intubation, both survival and extubation rates were low. Prognosis varied substantially by patient characteristics, with particularly poor outcomes in those with post-CPR status, dementia, or hypoalbuminemia. These findings highlight the need for individualized, goal-concordant decision-making when considering intubation in elderly patients.

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