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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 UGent, Joris Vermassen, Ruth Piers UGent, Dominique Benoit UGent, Lieven Annemans UGent and Johan Decruyenaere UGent (2017) MINERVA ANESTESIOLOGICA. 83(6). p.598-609
abstract
BACKGROUND: The 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. METHODS: A 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. RESULT: In 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. CONCLUSIONS: Most 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. (Cite this article as: Oeyen S, Vermassen J, Piers R, Benoit D, Annemans L, Decruyenaere J. Critically ill octogenarians and nonagenarians: evaluation of long-term outcomes, posthospital trajectories and quality of life one year and seven years after ICU discharge.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
Critical illness, Aged, 80 and over, Long term adverse effects, Quality of life, INTENSIVE-CARE-UNIT, PATIENTS AGED 80, CRITICAL ILLNESS, ELDERLY-PATIENTS, THE-LITERATURE, OLDER, SURVIVAL, COHORT, MULTICENTER, MORTALITY
journal title
MINERVA ANESTESIOLOGICA
Minerva Anestesiol.
volume
83
issue
6
pages
598 - 609
Web of Science type
Article
Web of Science id
000408938800011
ISSN
0375-9393
1827-1596
DOI
10.23736/S0375-9393.16.11434-8
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
8519171
handle
http://hdl.handle.net/1854/LU-8519171
date created
2017-05-02 11:12:54
date last changed
2018-03-19 10:54:47
@article{8519171,
  abstract     = {BACKGROUND: The aim of this study was to investigate long-term outcomes, posthospital trajectories, and quality of life (QOL) in patients {\textrangle}= 80 years admitted to the Intensive Care Unit (ICU) of a tertiary care hospital. 
METHODS: A 1-year prospective observational cohort analysis was performed. All consecutive patients {\textrangle}= 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{\textlangle}0.05. 
RESULT: In 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. 
CONCLUSIONS: Most 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. (Cite this article as: Oeyen S, Vermassen J, Piers R, Benoit D, Annemans L, Decruyenaere J. Critically ill octogenarians and nonagenarians: evaluation of long-term outcomes, posthospital trajectories and quality of life one year and seven years after ICU discharge.},
  author       = {Oeyen, Sandra and Vermassen, Joris and Piers, Ruth and Benoit, Dominique and Annemans, Lieven and Decruyenaere, Johan},
  issn         = {0375-9393},
  journal      = {MINERVA ANESTESIOLOGICA},
  keyword      = {Critical illness,Aged,80 and over,Long term adverse effects,Quality of life,INTENSIVE-CARE-UNIT,PATIENTS AGED 80,CRITICAL ILLNESS,ELDERLY-PATIENTS,THE-LITERATURE,OLDER,SURVIVAL,COHORT,MULTICENTER,MORTALITY},
  language     = {eng},
  number       = {6},
  pages        = {598--609},
  title        = {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},
  url          = {http://dx.doi.org/10.23736/S0375-9393.16.11434-8},
  volume       = {83},
  year         = {2017},
}

Chicago
Oeyen, Sandra, Joris Vermassen, Ruth Piers, Dominique Benoit, Lieven Annemans, and Johan Decruyenaere. 2017. “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.” Minerva Anestesiologica 83 (6): 598–609.
APA
Oeyen, S., Vermassen, J., Piers, R., Benoit, D., Annemans, L., & Decruyenaere, J. (2017). 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. MINERVA ANESTESIOLOGICA, 83(6), 598–609.
Vancouver
1.
Oeyen S, Vermassen J, Piers R, Benoit D, Annemans L, Decruyenaere J. 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. MINERVA ANESTESIOLOGICA. 2017;83(6):598–609.
MLA
Oeyen, Sandra, Joris Vermassen, Ruth Piers, et al. “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.” MINERVA ANESTESIOLOGICA 83.6 (2017): 598–609. Print.