Intensive Care Medicine

, Volume 32, Issue 7, pp 1045–1051 | Cite as

Decision-making process, outcome, and 1-year quality of life of octogenarians referred for intensive care unit admission

  • Maité Garrouste-Orgeas
  • Jean-François Timsit
  • Luc Montuclard
  • Alain Colvez
  • Olivier Gattolliat
  • François Philippart
  • Guillaume Rigal
  • Benoit Misset
  • Jean Carlet



To describe triage decisions and subsequent outcomes in octogenarians referred to an ICU.

Design and setting

Prospective observational study in the medical ICU in a tertiary nonuniversity hospital.


Cohort of 180 patients aged 80 years or over who were triaged for admission.


Age, underlying diseases, admission diagnoses, Mortality Probability Model score, and mortality were recorded. Self-sufficiency (Katz Index of Activities of Daily Living) and quality of life (modified Perceived Quality of Life scale and Nottingham Health Profile) were measured 1 year after triage.


In 132 patients (73.3%) ICU admission was refused, including 79 (43.8%) considered too sick to benefit. Factors independently associated with refusal were nonsurgical status, age older than 85 years, and full unit. Greater self-sufficiency was associated with ICU admission. Hospital mortality was 30/48 (62.5%), 56/79 (70.8%), 9/51 (17.6%), and 0/2 in the admitted, too sick to benefit, too well to benefit, and family/patient refusal groups, respectively; 1-year mortality was 34/48 (70.8%), 69/79 (87.3%), 24/51 (47%), and 0/2, respectively. Self-sufficiency was unchanged by ICU stay. Quality of life (known in only 28 patients) was significantly poorer for isolation, emotional, and mobility domains compared to the French general population matched on sex and age.


More than two-thirds of patients aged over 80 years referred to our ICU were denied admission. One year later self-sufficiency was not modified and quality of life was poorer than in the general population. These results indicate a need to discuss patient preferences before triage decisions.


Intensive care unit Triage Elderly Quality of life Ethics 



We thank A. Wolfe, MD, for helping to prepare this manuscript.

Supplementary material

134_2006_169_MOESM1_ESM.doc (98 kb)
Electronic Supplementary Material (DOC 100kb)


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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Maité Garrouste-Orgeas
    • 1
  • Jean-François Timsit
    • 2
  • Luc Montuclard
    • 3
  • Alain Colvez
    • 4
  • Olivier Gattolliat
    • 1
  • François Philippart
    • 1
  • Guillaume Rigal
    • 1
  • Benoit Misset
    • 1
  • Jean Carlet
    • 1
  1. 1.Medical ICUSaint Joseph HospitalParisFrance
  2. 2.Group of Epidemiology INSERM U-578 and Medical ICU Albert Michallon HospitalGrenobleFrance
  3. 3.Ethics DepartmentNecker HospitalParisFrance
  4. 4.Pole de Gerontologie and INSERMMontpellierFrance

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