• R Pirracchio, S Gallula, C Broche, C Ogereau, and D Payen.
• Service d'anesthésie réanimation, université Paris-5 Descartes, Sorbonne Paris Cité, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France. romainpirracchio@yahoo.fr
• Ann Fr Anesth Reanim. 2012 Feb 1;31(2):114-9.

ObjectiveTo estimate the adequacy between elderly patients' preference for ICU care when treated for a life-threatening pathology, and the strategy proposed by the medical team on scene.Study DesignProspective, observational study.Patients And MethodsAll patients older than 80 treated out-of-hospital for a life threatening pathology were included, except in case of language barrier, or when patients were unable to answer and absence of next-of-kin. The results of the questionnaire on quality of life and patients' preference concerning ICU care were compared to the responses provided blindly by the medical team.ResultsFifty-five patients were included. Quality of life as expressed by the patients was 7 (5-10) and by the physician 7 (6-8) (P=0.69). Thirty-six patients (65%) expressed the wish to be resuscitated, while ICU admission would have been proposed for 44 patients (80%) by the doctors (P=0.01). Among the 14 patients reluctant to ICU admission, 11 would have been proposed for ICU admission. In multivariate analysis, age (OR: 1.55 [1.04-2.32], P=0.03) and history of neurological pathology (OR: 11,91 [5.68->100], P=0.04) were associated with such an inadequacy.ConclusionThe inadequacy between elderly patients' preferences and doctors' opinion concerning ICU cares is frequent. The present results support a more systematic collection of patients' preferences when treated on scene for a life-threatening pathology.Copyright © 2011 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

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