Is this critically ill patient elderly or too old?

Premorbid functional status as a predictor of 1-year mortality and functional status in intensive care patients aged 80 years or older

“…Adding information about the PFS to our prediction model significantly improved its predictive ability for 1-year mortality. This result, in addition to the results of other studies [4,15,31], suggests that prediction models could be improved by incorporating factors reflecting physiological age in addition to chronological age.…”

Frequent problems and their management among mechanically ventilated critically ill elderly patients

“…Mechanically ventilated elderly patients experience pain from various sources, these include endotracheal suctioning, wound care, mouth care and repositioning (Ayasrah, 2016). Indications of intubation arise from difficulty in maintaining a patent airway, this is usually related to per-existing severe co-morbidities and degenerative physical changes (Guidet et al , 2018; Robert et al , 2017). Degenerative respiratory changes include loss of lung elasticity, increased the anteroposterior chest diameter, decreased inspiratory and expiratory muscle strength and declined sensitivity of respiratory centers.…”

“…Moreover, advanced age and frailty are associated with a higher risk factor of mortality among mechanically ventilated critically ill patients (Martin-Loeches et al , 2019). Elderly patients are admitted for numerous reasons, these include elective surgery, trauma, chronic obstructive pulmonary disease, heart failure and chronic renal failure (Robert et al , 2017; Aggarwal et al , 2017). Furthermore, alteration in respiratory physiology, which often leads to acute respiratory failure is a common reason for admission of elderly patients (Guidet et al , 2018).…”

Focus on ethics and palliative care in the intensive care unit

“…Another innovative area of ICU research focuses on the very elderly (≥ 80 years of age) and ,specifically, the need to identify patients in this rapidly growing subgroup who are most likely to benefit from ICU care [10]. Several recent observational studies have challenged the common view that very elderly patients gain little survival or quality of life benefit from ICU admission [11]. One such study conducted among 31 Dutch ICUs and more than 200,000 patients, with 13% being ≥ 80 years of age, found that annual risk-adjusted short-and long-term mortality rates significantly decreased between 2008 and 2014 for both the very elderly patients and those aged < 80 years [12].…”

“…Frailty and other pre-ICU functional status indicators have gained attention as potentially better predictors of poor outcomes than age or traditional ICU scoring systems [11]. A recent systematic review of ten observational studies including 3030 critically ill adults found that 30% were frail at baseline and that frail patients experienced higher rates of hospital and long-term mortality and lower rates of discharge to home compared to fit patients [15].…”