Factors that predict outcome of intensive care treatment in very elderly patients: a review

被引:115
作者
de Rooij, SE
Abu-Hanna, A
Levi, M
de Jonge, E
机构
[1] Univ Amsterdam, Acad Med Ctr, Dept Geriatr, NL-1105 AZ Amsterdam, Netherlands
[2] Univ Amsterdam, Acad Med Ctr, Dept Med Informat, NL-1105 AZ Amsterdam, Netherlands
[3] Univ Amsterdam, Acad Med Ctr, Dept Internal Med Cardiol & Pulm Dis, NL-1105 AZ Amsterdam, Netherlands
[4] Univ Amsterdam, Acad Med Ctr, Dept Intens Care, NL-1105 AZ Amsterdam, Netherlands
来源
CRITICAL CARE | 2005年 / 9卷 / 04期
关键词
D O I
10.1186/cc3536
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Introduction Advanced age is thought to be associated with increased mortality in critically ill patients. This report reviews available data on factors that determine outcome, on the value of prognostic models, and on preferences regarding life-sustaining treatments in ( very) elderly intensive care unit (ICU) patients. Methods We searched the Medline database ( January 1966 to January 2005) for English language articles. Selected articles were cross-checked for other relevant publications. Results Mortality rates are higher in elderly ICU patients than in younger patients. However, it is not age per se but associated factors, such as severity of illness and premorbid functional status, that appear to be responsible for the poorer prognosis. Patients' preferences regarding life-sustaining treatments are importantly influenced by the likelihood of a beneficial outcome. Commonly used prognostic models have not been calibrated for use in the very elderly. Furthermore, they do not address long-term survival and functional outcome. Conclusion We advocate the development of new prognostic models, validated in elderly ICU patients, that predict not only survival but also functional and cognitive status after discharge. Such a model may support informed decision making with respect to patients' preferences.
引用
收藏
页码:R307 / R314
页数:8
相关论文
共 63 条
  • [1] Predictive factors of in-hospital mortality in older patients admitted to a medical intensive care unit
    Bo, M
    Massaia, M
    Raspo, S
    Bosco, F
    Cena, P
    Molaschi, M
    Fabris, F
    [J]. JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2003, 51 (04) : 529 - 533
  • [2] Impact of nosocomial infections in trauma: Does age make a difference?
    Bochicchio, GV
    Joshi, M
    Knorr, KM
    Scalea, TM
    [J]. JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2001, 50 (04): : 612 - 617
  • [3] Prognosis of patients aged 80 years and over admitted in medical intensive care unit
    Boumendil, A
    Maury, E
    Reinhard, I
    Luquel, L
    Offenstadt, G
    Guidet, B
    [J]. INTENSIVE CARE MEDICINE, 2004, 30 (04) : 647 - 654
  • [4] A NEW METHOD OF CLASSIFYING PROGNOSTIC CO-MORBIDITY IN LONGITUDINAL-STUDIES - DEVELOPMENT AND VALIDATION
    CHARLSON, ME
    POMPEI, P
    ALES, KL
    MACKENZIE, CR
    [J]. JOURNAL OF CHRONIC DISEASES, 1987, 40 (05): : 373 - 383
  • [5] Long-term mortality and quality of life after prolonged mechanical ventilation
    Chelluri, L
    Im, KA
    Belle, SH
    Schulz, R
    Rotondi, AJ
    Donahoe, MP
    Sirio, CA
    Mendelsohn, AB
    Pinsky, MR
    [J]. CRITICAL CARE MEDICINE, 2004, 32 (01) : 61 - 69
  • [6] OUTCOME OF INTENSIVE-CARE OF THE OLDEST-OLD CRITICALLY ILL PATIENTS
    CHELLURI, L
    PINSKY, MR
    GRENVIK, ANA
    [J]. CRITICAL CARE MEDICINE, 1992, 20 (06) : 757 - 761
  • [7] LONG-TERM OUTCOME OF CRITICALLY ILL ELDERLY PATIENTS REQUIRING INTENSIVE-CARE
    CHELLURI, L
    PINSKY, MR
    DONAHOE, MP
    GRENVIK, A
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1993, 269 (24): : 3119 - 3123
  • [8] Ethical issues in end-of-life geriatric care: The approach of three monotheistic religions - Judaism, Catholicism, and Islam
    Clarfield, AM
    Gordon, M
    Markwell, H
    Alibhai, SMH
    [J]. JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2003, 51 (08) : 1149 - 1154
  • [9] INVESTIGATING THE IMPACT OF AGE ON OUTCOME OF MECHANICAL VENTILATION USING A POPULATION OF 41,848 PATIENTS FROM A STATEWIDE DATABASE
    COHEN, IL
    LAMBRINOS, J
    [J]. CHEST, 1995, 107 (06) : 1673 - 1680
  • [10] Measuring Prognosis and Case Mix in Hospitalized Elders: The Importance of Functional Status
    Kenneth E. Covinsky
    Amy C. Justice
    Gary E. Rosenthal
    Robert M. Palmer
    C. Seth Landefeld
    [J]. Journal of General Internal Medicine, 1997, 12 (4) : 203 - 208