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Langzeitprognose alter Patienten nach intensivmedizinischer Behandlung

Long-term outcome of elderly patients after intensive care treatment

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Zusammenfassung

Ältere Intensivpatienten haben generell eine höhere Mortalität als jüngere Patienten. Während die Art der Akuterkrankung und hohes Alter vor allem die kurzfristige Mortalität innerhalb der ersten Monate beeinflussen, hängt die Langzeitprognose mehr von Komorbiditäten und dem vorbestehenden funktionalen Status ab als vom chronologischen Alter allein. Des Weiteren leiden ältere Intensivpatienten oft noch viele Monate nach der Intensivtherapie unter einer reduzierten körperlichen Leistungsfähigkeit und den neuropsychologischen Konsequenzen ihrer kritischen Erkrankung und deren Behandlung. Nachsorgestudien zeigen, dass die körperlichen und psychischen Probleme ehemaliger Intensivpatienten nicht nur erheblich sein können, sondern bislang auch unvorhersehbar sind. Durch die ständige Verbesserung der intensivmedizinischen Therapie in den letzten Jahrzehnten überleben immer mehr Patienten ihre kritische Erkrankung. Es ist an der Zeit, durch „translationale“ Erforschung der kausalen Zusammenhänge zwischen intensivmedizinischer Intervention und Morbidität in der Nachintensivphase auch Einfluss auf die Qualität des Überlebens zu nehmen.

Abstract

In general, elderly patients have poorer outcomes than younger patients after intensive care treatment. Diagnosis at admission and high age mainly influence short-term mortality within the first few months after intensive care, while comorbitities and functional status are more pivotal regarding long-term mortality. Furthermore, the main reasons for reduced physical fitness and neurocognitive consequences that often last for many months after intensive care treatment of older patients are described. Many outcome studies show that physical und mental sequelae after intensive care treatment are not only substantial but also unpredictable. Due to the constant improvement of intensive care treatment during recent decades, increasingly more patients survive their acute critical disease. Now it is time to focus on translational research to discover causal relationships between intensive care treatment and morbidity during follow-up to improve the quality of survival.

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  1. Zentrale Notaufnahme, Klinikum Augsburg, Stenglinstr. 2, 86156, Augsburg, Deutschland

    M. Wehler

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  1. M. Wehler
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Wehler, M. Langzeitprognose alter Patienten nach intensivmedizinischer Behandlung. Med Klin 106, 29–33 (2011). https://doi.org/10.1007/s00063-011-0021-x

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