• Minerva anestesiologica · Jun 2017

    Comparative Study Observational Study

    Critically ill octogenarians and nonagenarians: evaluation of long-term outcomes, post-hospital trajectories and quality of life one year and seven years after ICU discharge.

    • Sandra Oeyen, Joris Vermassen, Ruth Piers, Dominique Benoit, Lieven Annemans, and Johan Decruyenaere.
    • Department of Intensive Care Medicine, Ghent University Hospital, Ghent, Belgium - sandra.oeyen@ugent.be.
    • Minerva Anestesiol. 2017 Jun 1; 83 (6): 598-609.

    BackgroundThe aim of this study was to investigate long-term outcomes, posthospital trajectories, and quality of life (QOL) in patients ≥80 years admitted to the Intensive Care Unit (ICU) of a tertiary care hospital.MethodsA 1-year prospective observational cohort analysis was performed. All consecutive patients ≥80 years admitted to the ICU were screened for inclusion. Demographics, comorbidity, organ failures, and outcomes were analyzed. QOL before admission, 3 months, 1 year, and 7 years after ICU discharge was assessed using EuroQoL-5D (EQ-5D) and Medical Outcomes Study 36-item Short Form Health Survey (SF-36) questionnaires. Statistical significance was attained at P<0.05.ResultsIn the study 131 patients with a median age of 83 years (IQR 81-85), a Charlson Comorbidity Index of 2 (IQR 0-4), a SOFA Score of 4 (3-8) upon ICU admission and an APACHE II Score of 20 (IQR 15-24) were included. ICU, hospital, 3 months, 1-year, and 7-year mortality rates were 17%, 29%, 39%, 50%, and 84% respectively. QOL decreased significantly over time. Most elderly considered QOL as acceptable and perceived only a worsening in physical functioning and self-care at long-term. Of the 1-year and 7-year survivors, 21% and 39% (P=0.122) lived in nursing homes, and 81% and 72% (P=0.423) preferred to be readmitted to an ICU department if necessarily.ConclusionsMost critically ill long-term elderly survivors lived at home, perceived their QOL as acceptable, and wanted to be readmitted to the ICU if necessary. In older patients, age alone is a poor indicator of the possible value to be gained from an ICU admission.

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