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Factors that predict outcome of intensive care treatment in very elderly patients: a review

INTRODUCTION: Advanced age is thought to be associated with increased mortality in critically ill patients. This report reviews available data on factors that determine outcome, on the value of prognostic models, and on preferences regarding life-sustaining treatments in (very) elderly intensive car...

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Autores principales: de Rooij, Sophia E, Abu-Hanna, Ameen, Levi, Marcel, de Jonge, Evert
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2005
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1269437/
https://www.ncbi.nlm.nih.gov/pubmed/16137342
http://dx.doi.org/10.1186/cc3536
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author de Rooij, Sophia E
Abu-Hanna, Ameen
Levi, Marcel
de Jonge, Evert
author_facet de Rooij, Sophia E
Abu-Hanna, Ameen
Levi, Marcel
de Jonge, Evert
author_sort de Rooij, Sophia E
collection PubMed
description INTRODUCTION: Advanced age is thought to be associated with increased mortality in critically ill patients. This report reviews available data on factors that determine outcome, on the value of prognostic models, and on preferences regarding life-sustaining treatments in (very) elderly intensive care unit (ICU) patients. METHODS: We searched the Medline database (January 1966 to January 2005) for English language articles. Selected articles were cross-checked for other relevant publications. RESULTS: Mortality rates are higher in elderly ICU patients than in younger patients. However, it is not age per se but associated factors, such as severity of illness and premorbid functional status, that appear to be responsible for the poorer prognosis. Patients' preferences regarding life-sustaining treatments are importantly influenced by the likelihood of a beneficial outcome. Commonly used prognostic models have not been calibrated for use in the very elderly. Furthermore, they do not address long-term survival and functional outcome. CONCLUSION: We advocate the development of new prognostic models, validated in elderly ICU patients, that predict not only survival but also functional and cognitive status after discharge. Such a model may support informed decision making with respect to patients' preferences.
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spelling pubmed-12694372005-10-28 Factors that predict outcome of intensive care treatment in very elderly patients: a review de Rooij, Sophia E Abu-Hanna, Ameen Levi, Marcel de Jonge, Evert Crit Care Research INTRODUCTION: Advanced age is thought to be associated with increased mortality in critically ill patients. This report reviews available data on factors that determine outcome, on the value of prognostic models, and on preferences regarding life-sustaining treatments in (very) elderly intensive care unit (ICU) patients. METHODS: We searched the Medline database (January 1966 to January 2005) for English language articles. Selected articles were cross-checked for other relevant publications. RESULTS: Mortality rates are higher in elderly ICU patients than in younger patients. However, it is not age per se but associated factors, such as severity of illness and premorbid functional status, that appear to be responsible for the poorer prognosis. Patients' preferences regarding life-sustaining treatments are importantly influenced by the likelihood of a beneficial outcome. Commonly used prognostic models have not been calibrated for use in the very elderly. Furthermore, they do not address long-term survival and functional outcome. CONCLUSION: We advocate the development of new prognostic models, validated in elderly ICU patients, that predict not only survival but also functional and cognitive status after discharge. Such a model may support informed decision making with respect to patients' preferences. BioMed Central 2005 2005-05-17 /pmc/articles/PMC1269437/ /pubmed/16137342 http://dx.doi.org/10.1186/cc3536 Text en Copyright © 2005 de Rooij et al.; licensee BioMed Central Ltd.
spellingShingle Research
de Rooij, Sophia E
Abu-Hanna, Ameen
Levi, Marcel
de Jonge, Evert
Factors that predict outcome of intensive care treatment in very elderly patients: a review
title Factors that predict outcome of intensive care treatment in very elderly patients: a review
title_full Factors that predict outcome of intensive care treatment in very elderly patients: a review
title_fullStr Factors that predict outcome of intensive care treatment in very elderly patients: a review
title_full_unstemmed Factors that predict outcome of intensive care treatment in very elderly patients: a review
title_short Factors that predict outcome of intensive care treatment in very elderly patients: a review
title_sort factors that predict outcome of intensive care treatment in very elderly patients: a review
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1269437/
https://www.ncbi.nlm.nih.gov/pubmed/16137342
http://dx.doi.org/10.1186/cc3536
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