Abstract
IntroductionOur objective was to describe self-sufficiency and quality of life one year after intensive care unit (ICU) discharge of patients aged 80 years or over.MethodsWe performed a prospective observational study in a medical-surgical ICU in a tertiary non-university hospital. We included patients aged 80 or over at ICU admission in 2005 or 2006 and we recorded age, admission diagnosis, intensity of care, and severity of acute and chronic illnesses, as well as ICU, hospital, and one-year mortality rates. Self-sufficiency (Katz Index of Activities of Daily Living) was assessed at ICU admission and one year after ICU discharge. Quality of life (WHO-QOL OLD and WHO-QOL BREF) was assessed one year after ICU discharge.ResultsOf the 115 consecutive patients aged 80 or over (18.2% of admitted patients), 106 were included. Mean age was 84 ± 3 years (range, 80 to 92). Mortality was 40/106 (37%) at ICU discharge, 48/106 (45.2%) at hospital discharge, and 73/106 (68.9%) one year after ICU discharge. In the 23 patients evaluated after one year, self-sufficiency was unchanged compared to the pre-admission status. Quality of life evaluations after one year showed that physical health, sensory abilities, self-sufficiency, and social participation had slightly worse ratings than the other domains, whereas social relationships, environment, and fear of death and dying had the best ratings. Compared to an age- and sex-matched sample of the general population, our cohort had better ratings for psychological health, social relationships, and environment, less fear of death and dying, better expectations about past, present, and future activities and better intimacy (friendship and love).ConclusionsAmong patients aged 80 or over who were selected at ICU admission, 80% were self-sufficient for activities of daily living one year after ICU discharge, 31% were alive, with no change in self-sufficiency and with similar quality of life to that of the general population matched on age and sex. However, these results must be interpreted cautiously due to the small sample of survivors.
Highlights
Our objective was to describe self-sufficiency and quality of life one year after intensive care unit (ICU) discharge of patients aged 80 years or over
We found that patients aged 80 years or over who were selected for ICU admission had no change in self-sufficiency one year after ICU discharge compared to the pre-admission status and had similar quality of life compared to age-and sex-matched individuals from the general population
Ratings were highest for social relationships, environment, and death and dying
Summary
Our objective was to describe self-sufficiency and quality of life one year after intensive care unit (ICU) discharge of patients aged 80 years or over. French census data show a steady increase in the proportion of elderly individuals and, in 2008, 3.9 million individuals were aged 75 to years and 1.4 million were older than years [2]. One consequence of this increasing lifespan is that a growing number of very elderly patients are being. One study detected no difference [8], another found decreases in specific domains with similar overall quality of life [6], and two studies found worse quality of life [7,9] These discrepancies may be ascribable to differences in the tools used to assess quality of life and to the use of tools designed for the general population that may be inappropriate in the very old [10]
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