The impact of intensive care admission criteria on elderly mortality

Abstract

SUMMARY OBJECTIVE To review systematically the influence of admission criteria on the mortality of elderly patients under intensive therapy. METHODS We performed a search on the PUBMED and BIREME databases by using the MeSH and DeCS terms “intensive care units”, “patient admission”, and “aged” in Portuguese, English, and Spanish. Only prospective and retrospective cohort studies were included. We analyzed the severity score, type of hospital admission, quality of life, co-morbidities, functionality, and elderly institutionalization. RESULTS Of the 1,276 articles found, thirteen were selected after evaluation of the inclusion and exclusion criteria. It was observed that the severity score, functionality, and co-morbidities had an impact on mortality. It was not possible to determine which severity score was more suitable. CONCLUSION We suggest that analysis of functionality, co-morbidities, and severity scores should be conducted to estimate the elderly mortality in relation to the admission to intensive care units.

Cuidados intensivos de enfermagem ao idoso com delirium: um protocolo de revisão de escopo

“…A national study carried out from 2002 to 2011 evidenced the magnitude of this expense difference that analyzed the hospitalization expenses, showing a value of expenses eight times superior in the male older adults regarding the adult age group (4)(5)(6) . Older adults patient care requires specific qualifications from health professionals due to its complexity, many times due to its comorbidities, and the necessity of continuous vigilance (7) . Among the main complications of older adults hospitalization in ICU is delirium, which according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) (8) , is a mental alteration secondary to a general medical condition, drug intoxication, or drug withdrawal characterized by cognition and consciousness disorders that develops in a short time, hours or days, and has a floating course.…”