Quality of life in patients aged 80 or over after ICU discharge
Tabah, Alexis, Philippart, Francois, Timsit, Jean-Francois, Willems, Vincent, Francais, Adrien, Leplege, Alain, Carlet, Jean, Bruel, Cedric, Misset, Benoit and Garrouste-Orgeas, Maite (2010), "Quality of life in patients aged 80 or over after ICU discharge ", Critical Care, 14, 1: R2.
Abstract:
INTRODUCTION: Our objective was to describe self-sufficiency and quality of life 1 year after intensive care unit (ICU) discharge of patients aged 80 years or over.
METHODS: We performed a prospective observational study in a medical-surgical ICU in a tertiary non-university hospital. We included patients aged 80 or over at ICU admission in 2005 or 2006 and we recorded age, admission diagnosis, intensity of care, and severity of acute and chronic illnesses, as well as ICU, hospital, and 1-year mortality rates. Self-sufficiency (Katz Index of Activities of Daily Living) was assessed at ICU admission and 1 year after ICU discharge. Quality of life (WHO-QOL OLD and WHO-QOL BREF) was assessed 1 year after ICU discharge.
RESULTS: Of the 115 consecutive patients aged 80 or over (18.2% of admitted patients), 106 were included. Mean age was 84 +/- 3 years (range, 80 - 92). Mortality was 40/106 (37%) at ICU discharge, 48/106 (45.2%) at hospital discharge, and 73/106 (68.9%) 1 year after ICU discharge. In the 23 patients evaluated after 1 year, self-sufficiency was unchanged compared to the pre-admission status. Quality of life evaluations after 1 year showed that physical health, sensory abilities, self-sufficiency, and social participation had slightly worse ratings than the other domains, whereas social relationships, environment, and fear of death and dying had the best ratings. Compared to an age- and sex-matched sample of the general population, our cohort had better ratings for psychological health, social relationships, and environment, less fear of death and dying, better expectations about past, present, and future activities and better intimacy (friendship and love).
CONCLUSIONS: Among patients aged 80 or over who were selected to ICU admission, 80% were self-sufficient for activities of daily living One year after ICU discharge, 31% were alive, with no change in self-sufficiency and with similar quality of life to that of the general population matched on age and sex. However, these results must be interpreted cautiously due to the small sample of survivors.