Long-term outcome of elderly patients requiring intensive care admission for abdominal pathologies: survival and quality of life.
BACKGROUND
Medical developments have allowed the management of patients aged over 70 years with severe abdominal pathologies requiring intensive care unit (ICU) admission. These patients require enhanced life support and present a high ICU mortality. We investigated the outcome and quality of life (QOL) of elderly patients 2 years after their ICU stay for abdominal pathologies.


METHODS
Patients aged 70 years or over with abdominal pathologies, admitted to our ICU over a period of 2 years, were included. Two years following their ICU stay, a letter informed the patients about the present study. Consent to participate was obtained by telephone. QOL was assessed by the Euro-QOL and Short Form-36 questionnaires. Other patient-centered outcomes were evaluated.


RESULTS
Overall, 2780 patients were admitted to the ICU during the study period; 141 (5%) patients were eligible; 112 of the 141 (79%) survived their ICU stay, 95 (67%) survived their hospital stay and 52 (37%) were alive 2 years after their ICU stay; 36 of the 52 survivors (69%) answered the questionnaire. Their QOL 2 years after their ICU stay was decreased in comparison with an age-matched population. Eighty-one per cent of patients lived at home and 57% were totally independent. They perceived their ICU stay as positive and 75% stated that they would agree to go through intensive care again. Factors associated with 2-year survival were the absence of co-morbidity, absence of malignancy and a lower Simplified Acute Physiology II score on ICU admission.


CONCLUSIONS
A high mortality rate and a decrease in QOL were observed in elderly patients with severe abdominal pathologies. Nonetheless, these patients were able to adapt well to their physical disabilities.
Merlani
P
P
Division of Surgical Intensive Care, Department of Anesthesiology, Pharmacology and Surgical Intensive Care, University Hospital of Geneva, Rue Micheli-du-Crest 24, 1211 Geneva 14, Switzerland. Paolo.Merlani@hcuge.ch
Chenaud
C
C
Mariotti
N
N
Ricou
B
B
D000368:Aged; D003422:Critical Care / Q000592:standards*; D005260:Female; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D016019:Survival Analysis