Trajectory of geriatric syndromes changes among elderly patients receiving intensive care

Abstract

Background: Geriatric syndromes are a series of clinical conditions in the elderly that do not fit into distinct categories, and has the characteristics of complex interaction among aging and multiple chronic diseases. They affect the quality of life of patients and are associated with disability. In the intensive care unit (ICU), life-maintenance and disease-control are the aims of the medical care, so geriatric syndromes care is often neglected and not given attention. Therefore, the medical care of elderly patients should gradually be shifted from the disease-oriented to geriatric symptom control in order to maintain elders’ life quality. Objective: The aim of this study was to expose the trajectory of geriatric syndromes changes among elderly receiving intensive care. Methods: The prospective survey was designed to collect data from the medical center at southern Taiwan for elderly patients who are older than 65 years old, have stayed in the ICU. A structured questionnaire will collect data associated with five geriatric symptoms, across four time points, 2 weeks before hospitalization, leaving ICU, discharge from hospital, and one month after discharge. The factors that associate with the changes of geriatric symptoms will be analyzed. Results: Research is still ongoing and is expected to recruit 250 patients; 58 patients have been recruited so far. Preliminary results showed 45.6% of subjects had at least one geriatric syndrome before admission; when they left the ICU, the incidents doubled, which mostly were urinary incontinence and delirium. After discharge from hospital, 49% of the elderly still have 2 or 3 geriatric syndromes, such as activities of daily living dysfunction, urinary and fecal incontinence. Discussion: The prevalence of geriatric syndromes among elderly patients who needed intensive care is high. Conclusion: The study reveals the current clinical issues in management of geriatric symptoms in ICU elderly patients and can provide research evidence to develop an effective critical care model for elderly patients in the future.