Outcome of Critically Ill Oldest‐Old Patients (Aged 90 and Older) Admitted to the Intensive Care Unit

Rellos, Konstantinos; Falagas, Matthew E.; Vardakas, Konstantinos Z.; Sermaides, G.; Michalopoulos, Argyris

doi:10.1111/j.1532-5415.2005.00544.x

Cited by 53 publications

(25 citation statements)

References 27 publications

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“…As the older population increases, the number of elderly patients who receive critical care services is expected to increase substantially over the next 10 to 20 years. Patients will be older, often with decreased functional reserves and increased comorbidities, and older patients are more likely to be died and discharge to nursing hospital or homes [1-3]. …”

Section: Introductionmentioning

confidence: 99%

Outcomes of very elderly (≥ 80 years) critical-ill patients in a medical intensive care unit of a tertiary hospital in Korea

Lee

et al. 2017

Korean J Intern Med

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Background/AimsThis study evaluated clinical characteristics and outcomes in very elderly (≥ 80 years of age) critical-ill patients admitted to a medical intensive care unit (MICU) in a regional single tertiary hospital.MethodsWe retrospectively evaluated prospectively collected data in the MICU for the period of December 2011 to May 2014. Patients were divided into ≥ 80 and < 80 years of age and clinical characteristics and outcomes were compared among these patients.ResultsA total of 468 patients were evaluated and 102 patients (21.7%) were ≥ 80 years of age. Overall mortality was 38.5% in the intensive care unit (ICU) and 44.7% in the hospital. There was no significant difference in ICU and in-hospital mortalities between those ≥ 80 years and those < 80 years (34.9% vs. 39.5% for ICU mortality; 40.6% vs. 45.9% for in-hospital mortality). Lengths of ICU and hospital stays were significantly longer in patients < 80 years compared to patients ≥ 80 years (10.57 ± 19.96 days vs. 8.19 ± 8.78 days for ICU stay; 27.95 ± 39.62 days vs. 18.17 ± 15.44 days for hospital stay). The rate of withholding intensive care in hospital stay over 48 hours was significantly higher in patients ≥ 80 years compared to patients < 80 years (22.9% vs. 11.8%). In multivariate analysis, weaning failure and withdrawal or withholding of intensive care in ICU was signiﬁcantly related to death in patients with age ≥ 80.ConclusionsClinical outcomes were not significantly different for very elderly critical-ill patients compared to those of their younger counterparts in the MICU in this study.

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Section: Introductionmentioning

confidence: 99%

Outcomes of very elderly (≥ 80 years) critical-ill patients in a medical intensive care unit of a tertiary hospital in Korea

Lee

et al. 2017

Korean J Intern Med

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“…There is some evidence to suggest that age is a restrictive factor for ICU admission [2,3] and that it determines treatment intensity [4,5]. However, even though an increased risk of mortality accompanies old age [6-10], most studies suggest that age alone does not represent a strong predictor for mortality [4]. However, few data concerning long-term survival after ICU admission in much older medical patients are currently available.…”

Section: Introductionmentioning

confidence: 99%

Long-term outcome in medical patients aged 80 or over following admission to an intensive care unit

et al. 2011

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“…This great heterogeneity in the results obtained may be due to significant differences in the methodology used and also in the patients (age, pre-morbid status, main diagnosis at ICU entry) and the type of ICU (surgical or medical) studied, making it difficult to obtain conclusions about the outcomes of specific subpopulations of elderly subjects after ICU discharge [3,6,8-10,16]. Boumendil et al .…”

Section: Introductionmentioning

confidence: 99%

Functional status and quality of life 12 months after discharge from a medical ICU in healthy elderly patients: a prospective observational study

et al. 2011

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IntroductionLong-term outcomes of elderly patients after medical ICU care are little known. The aim of the study was to evaluate functional status and quality of life of elderly patients 12 months after discharge from a medical ICU.MethodsWe prospectively studied 112/230 healthy elderly patients (≥65 years surviving at least 12 months after ICU discharge) with full functional autonomy without cognitive impairment prior to ICU entry. The main diagnoses at admission using the Acute Physiology and Chronic Health Evaluation III (APACHE III) classification diagnosis and length of ICU stay and ICU scores (APACHE II, Sepsis-related Organ Failure Assessment (SOFA) and OMEGA) at admission and discharge were collected. Comprehensive geriatric assessment included the presence of the main geriatric syndromes and the application of Lawton, Barthel, and Charlson Indexes and Informant Questionnaire on Cognitive Decline to evaluate functionality, comorbidity and cognitive status, respectively. The EuroQol-5D assessed quality of life. Data were collected at baseline, during ICU and ward stay and 3, 6 and 12 months after hospital discharge. Paired or unpaired T-tests compared differences between groups (continuous variables), whereas the chi-square and Fisher exact tests were used for comparing dichotomous variables. For variables significant (P ≤ 0.1) on univariate analysis, a forward multiple regression analysis was performed.ResultsOnly 48.9% of patients (mean age: 73.4 ± 5.5 years) were alive 12 months after discharge showing a significant decrease in functional autonomy (Lawton and Barthel Indexes) and quality of life (EuroQol-5D) compared to baseline status (P < 0.001, all). Multivariate analysis showed a higher Barthel Index and EQ-5D vas at hospital discharge to be associated factors of full functional recovery (P < 0.01, both). Thus, in patients with a Barthel Index ≥ 60 or EQ-5D vas ≥40 at discharge the hazard ratio for full functional recovery was 4.04 (95% CI: 1.58 to 10.33; P = 0.005) and 6.1 (95% CI: 1.9 to 19.9; P < 0.01), respectively. Geriatric syndromes increased after ICU stay and remained significantly increased during follow-up (P < 0.001).ConclusionsThe survival rate of elderly medical patients 12 months after discharge from the ICU is low (49%), although functional status and quality of life remained similar to baseline in most of the survivors. However, there was a two-fold increase in the prevalence of geriatric syndromes.

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Outcome of Critically Ill Oldest‐Old Patients (Aged 90 and Older) Admitted to the Intensive Care Unit

Abstract: All-cause in-hospital mortality was higher in the oldest-old group than in younger patients, but the mortality of this cohort of patients did not seem to reach a figure that would make physicians, relatives, and healthcare administrators decide against ICU care in this population.

Cited by 53 publications

References 27 publications

Outcomes of very elderly (≥ 80 years) critical-ill patients in a medical intensive care unit of a tertiary hospital in Korea

Outcomes of very elderly (≥ 80 years) critical-ill patients in a medical intensive care unit of a tertiary hospital in Korea

Long-term outcome in medical patients aged 80 or over following admission to an intensive care unit

Functional status and quality of life 12 months after discharge from a medical ICU in healthy elderly patients: a prospective observational study

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