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Functional outcome in intensive care older survivors

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Abstract

Background

Most of the research focused on mortality and neglected functional outcome in older patients admitted to intensive care unit (ICU).

Aims

The aim of this study is evaluating functional outcome in older patients admitted to ICU.

Methods

A cross-sectional study of 203 elderly patients admitted to Geriatric ICU in Ain Shams University Hospitals and followed for 90 days after ICU discharge to track their functional level and other adverse outcomes.

Results

The mean age for the cohort was 72.6 ± 8.8. Seventy-three patients survived after 3 months (36%). Only 42 patients out of 73 survivors maintained the same level of functions (58%). Factors related to functional decline were Charlson Comorbidity Index and infections acquired within 3 months after discharge. ICU scores, like APACHE and SAPS II scores were not effective in predicting functional outcomes.

Conclusions

Comorbidity burden and infections acquired within 3 months after discharge are important determinants of long-term functional level after ICU admission.

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References

  1. US Census Bureau. Population Projections of the United States by Age, Sex, Race, Hispanic Origin and Nativity: 1999–2100 Washington: US Census Bureau; 2000

  2. Vosylius S, Sipylaite J, Ivaskevicius J (2005) Determinants of outcome in elderly patients admitted to the intensive care unit. Age Ageing 34:157–162

    Article  Google Scholar 

  3. Esteban A, Anzueto A, Frutos-Vivar F et al (2004) Outcome of older patients receiving mechanical ventilation. Intensive Care Med 30:639–646

    Article  Google Scholar 

  4. Tang EY, Hsu LF, Lam KN, Pang WS (2003) Critically ill elderly who require mechanical ventilation: the effects of age on survival outcomes and resource utilisation in the medical intensive care unit of a general hospital. Ann Acad Med Singapore 32:691–696

    CAS  PubMed  Google Scholar 

  5. Chelluri L, Im KA, Belle SH et al (2004) Long-term mortality and quality of life after prolonged mechanical ventilation. Crit Care Med 32:61–69

    Article  Google Scholar 

  6. Boumendil A, Maury E, Reinhard I, Luquel L, Offenstadt G, Guidet B (2004) Prognosis of patients aged 80 years and over admitted in medical intensive care unit. Intensive Care Med 30:647–654

    Article  Google Scholar 

  7. De Rooij SE, Govers A, Korevaar JC, Abu-Hanna A, Levi M, de Jonge E (2006) Short-term and long-term mortality in very elderly patients admitted to an intensive care unit. Intensive Care Med 32:1039–1044. https://doi.org/10.1007/s00134-006-0171-0

    Article  PubMed  Google Scholar 

  8. De Rooij SE, Govers AC, Korevaar JC, Giesbers AW, Levi M, De Jonge E (2008) Cognitive, functional and quality of life outcomes of patients aged 80 and older who survived at least 1 year after planned or unplanned surgery or medical intensive care treatment. J Am Geriatr Soc 56:816–822. https://doi.org/10.1111/j.1532-5415.2008.01671.x

    Article  PubMed  Google Scholar 

  9. Chelluri L, Pinsky MR, Donahoe MP, Grenvik A (1993) Long-term outcome of critically ill elderly patients requiring intensive care. JAMA 269:3119–3123. https://doi.org/10.1001/jama.269.24.3119

    Article  CAS  PubMed  Google Scholar 

  10. Montuclard L, Garrouste-Orgeas M, Timsit JF, Misset B, de Jonghe B, Carlet J (2000) Outcome, functional autonomy, and quality of life of elderly patients with a long-term intensive care unit stay. Crit Care Med 28:3389–3395. https://doi.org/10.1097/00003246-200010000-00002

    Article  CAS  PubMed  Google Scholar 

  11. Garrouste-Orgeas M, Timsit JF, Montuclard L et al (2006) Decision-making process, outcome, and 1-year quality of life of octogenarians referred for intensive care unit admission. Intensive Care Med 32:1045–1051. https://doi.org/10.1007/s00134-006-0169-7

    Article  PubMed  Google Scholar 

  12. Charlson M, Szatrowski TP, Peterson J, Gold J (1994) Validation of a combined comorbidity index. J Clin Epidemiol 47:1245–1251

    Article  CAS  Google Scholar 

  13. Knaus WA, Draper EA, Wagner DP, Zimmerman JE (1985) APACHE II: a severity of disease classification system. Crit Care Med 13:818–829

    Article  CAS  Google Scholar 

  14. Gall JR, Lemeshow S, Saulnier F (1993) A new simplified acute physiology score (SAPS II) based on a European/North American multicenter study. JAMA 270:2957–2963

    Article  Google Scholar 

  15. Katz S, Downs TD, Cash HR, Grotz RC (1970) Progress in the development of the index of ADL. Gerontologist 10:20–30

    Article  CAS  Google Scholar 

  16. Lawton MP, Brody EM (1969) Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 9:179–186

    Article  CAS  Google Scholar 

  17. Kaukonen KM, Bailey M, Suzuki S, Pilcher D, Bellomo R (2014) Mortality related to severe sepsis and septic shock among critically ill patients in Australia and New Zealand, 2000–2012. JAMA 311:1308–1316

    Article  CAS  Google Scholar 

  18. Agard AS, Egerod I, Tønnesen E, Lomborg K (2012) Struggling for independence: a grounded theory study on convalescence of ICU survivors 12 months post ICU discharge. Intensive Crit Care Nurs 28:105–113

    Article  CAS  Google Scholar 

  19. Boyd CM, Ricks M, Fried LP et al (2009) Functional decline and recovery of activities of daily living in hospitalized, disabled older women. J Am Geriatr Soc 57:1757–1766

    Article  Google Scholar 

  20. Iwashyna TJ, Theodore J, Smith DM, Langa KM (2010) Long-term cognitive impairment and functional disability among survivors of severe sepsis. JAMA 304:1787–1794

    Article  CAS  Google Scholar 

  21. Johnston J, Wagner DP, Timmons S, Welsh D, Tsevat J, Render ML (2000) Impact of different measures of comorbid disease on predicted mortality of intensive care unit patients. Med Care 40:929–940

    Article  Google Scholar 

  22. Quan H, Li B, Couris CM et al (2011) Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries. Am J Epidemiol 173:676–682

    Article  Google Scholar 

  23. Núñez JE, Núñez E, Fácila L et al (2004) Prognostic value of Charlson comorbidity index at 30 days and 1 year after acute myocardial infarction. Rev Esp Cardiol 57:842–849

    Article  Google Scholar 

  24. Buntinx F, Niclaes L, Suetens C, Jans B, Mertens R, Van den Akker M (2002) Evaluation of Charlson’s comorbidity index in elderly living in nursing homes. J Clin Epidemiol 55:1144–1147

    Article  CAS  Google Scholar 

  25. Tripathy S, Mishra JC, Dash S (2014) Critically ill elderly patients in a developing world–mortality and functional outcome at 1 year: a prospective single-center study. J Crit Care 29:474.e7

    Article  Google Scholar 

  26. Zimmerman JE, Alzola C, Von Rueden KT (2003) The use of benchmarking to identify top performing critical care units: a preliminary assessment of their policies and practices. J Crit Care 18:76–86

    Article  Google Scholar 

  27. De Rooij SE, Abu-Hanna A, Levi M (2005) de Jonge E (2005) Factors that predict outcome of intensive care treatment in very elderly patients: a review. Crit Care 9:R307–R314

    Article  Google Scholar 

  28. Covinsky KE, Kenneth E, Counsell SR, Pine ZM, Walter LC, Chren MM (2000) Functional status before hospitalization in acutely ill older adults: validity and clinical importance of retrospective reports. J Am Geriatr Soc 48:164–169

    Article  CAS  Google Scholar 

  29. Greysen SR, Cenzer I, Boscardin WJ, Covinsky KE (2017) Functional impairment: An unmeasured marker of medicare costs for postacute care of older adults. J Am Geriatr Soc 65:1996–2002

    Article  Google Scholar 

  30. Herridge MS, Moss M, Hough CL, Hopkins RO, Rice TW, Bienvenu OJ (2016) Recovery and outcomes after the acute respiratory distress syndrome (ARDS) in patients and their family caregivers. Intensive Care Med 42:725–738

    Article  Google Scholar 

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Authors and Affiliations

  1. Geriatrics and Gerontology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

    Safaa Hussein Ali & Rania Mohammed Abou-Hashem

  2. Anaesthesia and Pain Management Department, EL Matarya Teaching Hospital, Cairo, Egypt

    Remon Asaad Nasr

Authors
  1. Safaa Hussein Ali
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  2. Remon Asaad Nasr
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  3. Rania Mohammed Abou-Hashem
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Corresponding author

Correspondence to Rania Mohammed Abou-Hashem.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of Local Ethics Committee of Geriatrics and Gerontology medicine, Faculty of Medicine, Ain Shams University.

Informed consent

Informed oral consent was obtained from all patients included in the study and/or their next of kin with the presence of a nurse prior to enrollment.

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Ali, S.H., Nasr, R.A. & Abou-Hashem, R.M. Functional outcome in intensive care older survivors. Aging Clin Exp Res 33, 1609–1617 (2021). https://doi.org/10.1007/s40520-020-01679-w

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  • DOI: https://doi.org/10.1007/s40520-020-01679-w

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