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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 (UGent) , Ruth Piers (UGent) , Dominique Benoit (UGent) , Lieven Annemans (UGent) and Johan Decruyenaere (UGent)
(2017) MINERVA ANESTESIOLOGICA. 83(6). p.598-609
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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.
Keywords
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

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MLA
Oeyen, Sandra 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.
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.
Chicago author-date
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.
Chicago author-date (all authors)
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.
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.
IEEE
[1]
S. Oeyen, J. Vermassen, R. Piers, D. Benoit, L. Annemans, and J. Decruyenaere, “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, vol. 83, no. 6, pp. 598–609, 2017.
@article{8519171,
  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.},
  author       = {Oeyen, Sandra and Vermassen, Joris and Piers, Ruth and Benoit, Dominique and Annemans, Lieven and Decruyenaere, Johan},
  issn         = {0375-9393},
  journal      = {MINERVA ANESTESIOLOGICA},
  keywords     = {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},
}

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