[Intensive care medicine in advanced age from the viewpoint of the internist].
BACKGROUND
The percentage of elderly patients in ICUs has doubled over the last 20 years; in the case of the over-seventy-year-olds it is at present about 30%.
The mean length of stay in the ICU and hospital, and the average costs incurred, are not significantly higher in the case of the elderly. With increasing age, mortality rises steadily, being about 20% for geriatric patients in the ICU, 37% in hospital, and 52, cumulative, after one year. Nevertheless, elderly patients benefit in particular from intensive care. Their relative mortality rate in comparison with the general population of the same age is only slightly elevated. In view of the very high mortality following cardiopulmonary resuscitation of geriatric patients, it would make good sense to limit the indication in particular cases. Quality of life after discharge from ICU care and thereafter is appreciably lower in comparison with younger patients, but acceptance of intensive care is very good among elderly patients, too. As a study we carried out in our "toxicological" ICU showed, prognostic scoring systems for the elderly are not particularly reliable, and the geriatric skills and the knowledge of the physician weigh heavier.


CONCLUSIONS
We consider intensive care in the elderly to be both beneficial and efficient, for despite an increase in the mortality rate, a satisfactory quality of life is achieved.
Horn
J
J
Lehrstuhl für Inere Medizin und Gerontologie, Universität Erlangen-Nürnberg.
Geier
H J
HJ
Seefried
G
G
Platt
D
D
D000368:Aged; D003362:Cost-Benefit Analysis; D003422:Critical Care / Q000191:economics / Q000379:methods*; D005858:Germany; D006801:Humans; D007902:Length of Stay / Q000191:economics; D010342:Patient Acceptance of Health Care; D012151:Resuscitation; D015996:Survival Rate
Intensivmedizin im höheren Alter aus der Sicht des Internisten.