Prognosis and quality of life of elderly patients after intensive care

Conti, Marco; Merlani, Paolo; Ricou, Bara

doi:10.4414/smw.2012.13671

Cited by 25 publications

(31 citation statements)

References 71 publications

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“…After facing severe illness, older patients are likely to assign higher scores to their quality of life. (14,15,17) A study with elderly individuals aged 80 years or older also showed that quality of life was preserved in the majority of patients after ICU admission. (18) …”

Section: Discussionmentioning

confidence: 99%

Functional ability in younger and older elderlies after discharge from the intensive care unit. A prospective cohort

Dietrich¹,

Cardoso²,

Vargas³

et al. 2017

Revista Brasileira De Terapia Intensiva

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ObjectiveTo compare the functional capacity of younger elderly individuals (60 to 79 years old) with that of older elderly individuals (≥ 80 years old) during the first 6 months after discharge from the intensive care unit.MethodsA multicenter prospective cohort study was conducted, in which data on intensive care unit admission and outcomes after hospital discharge (immediate post-discharge, after 3 months and after 6 months) were collected. Muscle strength was evaluated through the protocol of the Medical Research Council and dynamometry (handgrip); the ability to perform activities of daily life and functional independence were assessed by the Barthel index and the usual level of physical activity (International Physical Activity Questionnaire); and quality of life was assessed by the 12-Item Short-Form Health Survey Version 2.ResultsAmong the 253 patients included, 167 were younger elderly (between 61 and 79 years old), and 86 were older elderly (≥ 80 years old). During the sixth month of evaluation, the older elderlies presented a higher need for a caregiver (69.0% versus 49, 5%, p = 0.002). Functional capacity prior to intensive care unit admission and in the third month after discharge was lower in older elderlies than in younger ones (Barthel prior to the intensive care unit: 73.0 ± 30.0 versus 86.5 ± 22.6; p <0.001, Barthel in the third month: 63.5 ± 34.0 versus 71.5 ± 35.5, p = 0.03), as was the usual level of physical activity (International Physical Activity Questionnaire in the third month: active/very active 3.4% versus 18.3%, no physical activity 64.4% versus 39.7%, p < 0.001, and International Physical Activity Questionnaire in the sixth month: active/very active 5.8% versus 20.8%, no physical activity 69.2% versus 43.4%, p = 0.005). Older elderlies had lower muscle strength when assessed according to handgrip in both the dominant (14.5 ± 7.7 versus 19.9 ± 9.6, p = 0.008) and non-dominant limb (13.1 ± 6.7 versus 17.5 ± 9.1, p = 0.02). There were no differences in functional capacity loss or reported quality of life between the age groups.ConclusionAlthough there were great functional capacity losses after discharge from the intensive care unit in both age groups, there was no difference in the magnitude of functional capacity loss between younger (60 to 79 years) and older elderly individuals (≥ 80 years old) during the first 6 months after discharge from the intensive care unit.

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Section: Discussionmentioning

confidence: 99%

Functional ability in younger and older elderlies after discharge from the intensive care unit. A prospective cohort

Dietrich¹,

Cardoso²,

Vargas³

et al. 2017

Revista Brasileira De Terapia Intensiva

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“…The issues regarding end-of-life care for elderly patients even in the ICU are currently being raised with greater frequency [7, 8]. We therefore wish to highlight the issue of end-of-life care and decision-making in the ICU focusing on NDT.…”

Section: Discussionmentioning

confidence: 99%

Nondialytic Therapy for Elderly Patients in a Critical Care Setting

Ishikawa

Sakamoto

2014

Case Rep Nephrol Dial

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It is frequently necessary to admit critically ill elderly patients to intensive care units (ICUs) due to their physiological impairments and co-morbidities. Several life-sustaining therapies such as mechanical ventilation are performed as necessary treatment in these ICUs. Sometimes renal replacement therapy (i.e. dialysis) is considered for elderly patients with complicating serious renal insufficiency. However, although the necessity for dialysis is recognized, some elderly patients may not benefit from this care because of their limited life expectancy. Until recently, life-sustaining support for critically ill elderly patients in Japan has been used routinely, regardless of the medical futility. The issue of providing better end-of-life care for elderly patients even in the ICU is now being raised frequently. We therefore wish to highlight the issue of end-of-life care and decision-making in the ICU, focusing on nondialytic therapy (NDT). The aim of this article was to assess whether NDT is an acceptable optional care for critically ill elderly patients with serious kidney diseases, even in the ICU. We hope our experiences may be helpful to physicians with an interest in decision-making and end-of-life care.

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“…Além disso, a avaliação inicial antes do internamento na UCI foi realizada, o que é crucial quando se estuda o impacto da doença crítica (Oeyen, et al, 2010). Adicionalmente, levando em consideração que a QVRS pode diminuir ao longo do tempo (Hopman et al, 2014) e há diferentes pontuações de QV em pessoas com a mesma idade cronológica (Conti, Merlani, & Ricou, 2012), entende-se que faz sentido que os idosos voltem a um nível semelhante ao de antes do internamento, a fim de saber se as alterações refletem o impacto da doença crítica ou um nível baixo antes dos cuidados intensivos.…”

Section: Sintomas Depressivos Em Idosos Que Estiveram Internados Numaunclassified

“…Este fenómeno origina a necessidade da existência de mais recursos em saúde, incluindo os cuidados intensivos (Conti, Merlani, & Ricou, 2012), onde os idosos representam entre 30% até quase 50% do total da população da UCI na Europa (Castelló, Cabello, Goixart, Llanes, & Rodríguez-Pozo, 2008;López-Soto, 2005). Neste contexto, a adequação do sistema de saúde à população idosa assume-se como um importante desafio (Chamie, 2010).…”

Section: Introductionunclassified

“…Tendo em consideração que as pessoas com idade igual ou superior a 65 anos constituem um grupo relevante da população das UCIs (Conti, Merlani, & Ricou, 2012), é fundamental avaliar os sintomas depressivos nos idosos que são internados nas UCIs, para conhecer o impacto dos cuidados intensivos na qualidade de vida desses doentes e, consequentemente, melhorar os cuidados de saúde prestados a essa população.…”

Section: Introductionunclassified

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