Acceptable long-term outcome in elderly intensive care unit patients

TY - JOUR

T1 - Acceptable long-term outcome in elderly intensive care unit patients

AU - Schrøder, Morten

AU - Poulsen, Jesper Brøndum

AU - Perner, Anders

PY - 2011/7

Y1 - 2011/7

N2 - INTRODUCTION: The number of elderly intensive care unit (ICU) patients is increasing. We therefore assessed the longterm outcome in the elderly following intensive care. MATERIAL AND METHODS: The outcome status for 91 elderly (≥ 75 years) and 659 non-elderly (18-74 years) ICU patients treated in the course of a one-year period was obtained. A total of 36 of 37 eligible elderly survivors were interviewed about their health-related quality of life (HRQOL), social services and their wish for intensive care. RESULTS: The mortality (54% at follow-up and 64% after one year) was higher in the elderly ICU patients than in nonelderly ICU patients (33% and 37%, respectively, p < 0.001) and than in the Danish background population ≥ 75 years (9%, p < 0.001). Elderly ICU survivors had significantly lower HRQOL scores in two of four physical domains and a lower physical component summary score than age-matched controls (38 (31-46) versus 43 (36-52), p = 0.01). However, ICU survivors scored like controls in three of four mental domains and higher than controls in "mental health" (p = 0.04). At follow-up, 89% had returned to live in their own home. CONCLUSION: Elderly ICU patients had high long-term mortality rates and survivors had impaired physical function. Nevertheless, their mental function was in line with that of the background population and the majority had returned to their home and wished intensive care again. FUNDING: The study was supported only by Rigshospitalet's Research Council. TRIAL REGISTRATION: not relevant A growing proportion of the elderly in the general population and advancement in medical and surgical treatments collectively contribute to the observed increase in the number of elderly patients at intensive care units (ICU) [1-3]. As a consequence, more elderly are expected to survive intensive care, even though their long-term survival is known to be low with reported rates of 34% to 52% [1, 2, 4-8]. However, survival rates alone are not adequate or exhaustive means for describing the outcome of intensive care wherefore focus is increasingly paid to health-related quality of life (HRQOL) as a measure of treatment outcome [9]. Knowledge about HRQOL after intensive care may help improve patient management, information to survivors and their relatives, as well as policy making and resource allocation [9, 10]. Studies on HRQOL in the elderly after ICU have previously been published, but inclusion rates have varied from 61-80% which may have affected their results [2, 4, 5, 7, 11]. We therefore studied the long-term outcome - measured by mortality and HRQOL - in elderly patients following intensive care.

AB - INTRODUCTION: The number of elderly intensive care unit (ICU) patients is increasing. We therefore assessed the longterm outcome in the elderly following intensive care. MATERIAL AND METHODS: The outcome status for 91 elderly (≥ 75 years) and 659 non-elderly (18-74 years) ICU patients treated in the course of a one-year period was obtained. A total of 36 of 37 eligible elderly survivors were interviewed about their health-related quality of life (HRQOL), social services and their wish for intensive care. RESULTS: The mortality (54% at follow-up and 64% after one year) was higher in the elderly ICU patients than in nonelderly ICU patients (33% and 37%, respectively, p < 0.001) and than in the Danish background population ≥ 75 years (9%, p < 0.001). Elderly ICU survivors had significantly lower HRQOL scores in two of four physical domains and a lower physical component summary score than age-matched controls (38 (31-46) versus 43 (36-52), p = 0.01). However, ICU survivors scored like controls in three of four mental domains and higher than controls in "mental health" (p = 0.04). At follow-up, 89% had returned to live in their own home. CONCLUSION: Elderly ICU patients had high long-term mortality rates and survivors had impaired physical function. Nevertheless, their mental function was in line with that of the background population and the majority had returned to their home and wished intensive care again. FUNDING: The study was supported only by Rigshospitalet's Research Council. TRIAL REGISTRATION: not relevant A growing proportion of the elderly in the general population and advancement in medical and surgical treatments collectively contribute to the observed increase in the number of elderly patients at intensive care units (ICU) [1-3]. As a consequence, more elderly are expected to survive intensive care, even though their long-term survival is known to be low with reported rates of 34% to 52% [1, 2, 4-8]. However, survival rates alone are not adequate or exhaustive means for describing the outcome of intensive care wherefore focus is increasingly paid to health-related quality of life (HRQOL) as a measure of treatment outcome [9]. Knowledge about HRQOL after intensive care may help improve patient management, information to survivors and their relatives, as well as policy making and resource allocation [9, 10]. Studies on HRQOL in the elderly after ICU have previously been published, but inclusion rates have varied from 61-80% which may have affected their results [2, 4, 5, 7, 11]. We therefore studied the long-term outcome - measured by mortality and HRQOL - in elderly patients following intensive care.

M3 - Journal article

SN - 2245-1919

VL - 58

SP - A4297

JO - Danish Medical Journal

JF - Danish Medical Journal

IS - 7

ER -