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Care of the Elderly Critical Care Patient

  • Christos Colovos
  • Nicolas Melo
  • Daniel Margulies
Chapter

Abstract

Critical care poses significant challenges for all patients. However, the elderly population requires extra vigilance owing to age-related changes in physiology, multiple medical comorbidities, polypharmacy, and deconditioning. The elderly, defined here as persons 65 years or older, account for 14.5% of the population and account for 42–52% of ICU admissions. The impact of the elderly will dramatically increase as their population will double to 70 million in 2030. Given increasing life expectancy (78.8 years in the United States), and the fact that this segment of the population accounts for 42–52% of ICU admissions [1, 2], the impact on health care and critical care is immense. Mortality is increased in the elderly, and studies demonstrate an 18.7% mortality for surgical patients, up to 26.5% ICU mortality for medical cause, and up to 50% mortality 1 year after discharge [1–3]. Aging affects every system in the body, and combined with comorbidities, multiple medications, and frequent end-of-life ethical issues, caring for these patients poses significant challenges in today’s health-care environment [4–13]. Knowing how to care for this special population with age-related physiologic changes and a lack of physiologic reserve compared to the general population is of paramount importance.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Christos Colovos
    • 1
  • Nicolas Melo
    • 2
  • Daniel Margulies
    • 3
    • 4
  1. 1.Department of Surgery, Cedars-Sinai Medical CenterLos AngelesUSA
  2. 2.Department of Surgery, Division of Acute Care SurgeryCedars-Sinai Medical CenterLos AngelesUSA
  3. 3.Section of Trauma, Emergency Surgery & Surgical Intensive Care and Professor of SurgeryCedars-Sinai Medical CenterLos AngelesUSA
  4. 4.University of California at Los Angeles David Geffen School of MedicineLos AngelesUSA

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