Objective: Globally, more octogenarian patients require hospitalization for cardiovascular conditions, but deciding between Coronary Intensive Care Units (CICU) and general medical wards (GMW) is challenging due to frailty and comorbidities.

Materials and Methods: This retrospective study at a tertiary heart center (March 2017-December 2022) included octogenarian patients (≥80 years) hospitalized for acute coronary syndrome (ACS), heart failure (HF), or cardiac arrhythmias. Patients were categorized into CICU (n=512) and GMW (n=548) groups, with analysis of clinical, demographic, and outcomes data.

Results: Mean ages were similar between CICU and GMW groups (84.8±6.8 vs. 85.0±5.8 years; p=0.440). In-hospital mortality was higher in the CICU group (18.0% vs. 10.0%, p<0.001), as were complications like sepsis (10.5% vs. 6.9%, p=0.024), acute kidney injury (15.8% vs. 10.2%, p=0.008), and delirium (32.0% vs. 17.5%, p<0.001). Logistic regression showed STEMI (OR=2.80, p<0.001), intubation (OR=3.50, p<0.001), acute kidney injury (OR=2.10, p<0.001), sepsis (OR=2.30, p<0.001), and delirium (OR=1.50, p=0.002) as significant predictors of mortality.

Conclussion: CICU admission, while critical for high-risk octogenarians, especially those with STEMI, correlates with increased mortality and complications. Effective patient selection and preventive measures are vital to improve outcomes in this vulnerable group.