Aim: Predicting the prognosis and mortality of older adults in intensive care units (ICUs) is vital. We studied the parameters that affect and predict outcomes in patients over 65 years of age during ICU follow-up.

Study Design: We retrospectively analyzed data from patients aged 65 and older who were followed in Akdeniz University intensive care units between June 2022 and December 2023. Acute Physiology and Chronic Health Evaluation II (APACHE-II) scores measured on the first day, Sequential Organ Failure Assessment (SOFA) scores measured within the first day and on the third day of admission (Delta SOFA) were recorded. The APACHE II and Delta SOFA scores were compared between the survivor and deceased patient groups.

Results: Parameters of 161 patients were determined. The mortality rate was 51.55% after 45 days of follow-up. Existing hematologic malignancy (p=0.028), hospitalization in intensive care units due to sepsis (p=0.007), Delta Sequential Organ Failure Assessment (ΔSOFA), APACHE-II scores (p<0.001 for both), and steroid therapy (p=0.009) were independent risk factors for mortality. A decrease in SOFA and APACHE-II scores increased the likelihood of survival (p<0.001) in older adults followed up in ICUs. The Delta SOFA score was found to be significantly more predictive of mortality than the APACHE-II score.

Conclusions: Delta SOFA and APACHE-II scores during follow-up are associated with pre-dicting mortality. The mortality prediction ability of Delta SOFA fluctuations surpasses that of APACHE-II. These parameters may provide clinical utility in the follow-up of patients, the prediction of prognosis and mortality, and the evaluation of treatment response.