Cognitive, functional, and quality-of-life outcomes of patients aged 80 and older who survived at least 1 year after planned or unplanned surgery or medical intensive care treatment.
OBJECTIVE
To investigate long-term cognitive, functional, and quality-of-life outcomes in very elderly survivors at least 1 year after planned or unplanned surgery or medical intensive care treatment.


METHODS
Retrospective cohort study.


METHODS
General, 1,024-bed, tertiary university teaching hospital in The Netherlands.


METHODS
Two hundred four survivors of a cohort of 578 patients admitted to the medical-surgical intensive care unit (ICU) between January 1997 and December 2002 and alive in December 2003. The majority of survivors underwent elective surgery.


METHODS
From December 2003 until February 2004, data were collected from 190 patients and 169 relatives. The measures were: Informant Questionnaire on Cognitive Decline short form (IQCODE-SF) (cognition), modified Katz index of activities of daily living (ADLs) (functional status), and EuroQol (EQ-5D) (health-related quality of life). The patients themselves completed the modified Katz ADL index and EQ-5D forms; their caregivers completed the ADL caregiver version and IQCODE-SF.


RESULTS
The mean age at admission+/-standard deviation was 81.7+/-2.4, and the median time after discharge was 3.7 years (range 1-5.9 years). Of the ICU patients who had planned surgery, 57% survived, compared with 11% of the unplanned surgical admissions and 10% of the medical patients. Three-quarters (74.3%) of the patients who lived at home before ICU admission remained at home at follow-up. Eighty-three percent had no severe cognitive impairment, and 76% had no severe physical limitations (33% had moderate, 40% had mild, and 3% had no limitations). The perceived quality of life was similar to that of an age-matched general population.


CONCLUSIONS
Long-term survivors of ICU treatment received at the age of 80 and older showed fair-to-good cognitive and physical functioning and quality of life, although few patients who underwent unplanned surgery or who were admitted to the ICU for medical reasons survived.
de Rooij
Sophia E J A
SE
Department of Internal Medicine and Geriatrics, Academic Medical Center, Amsterdam, The Netherlands. s.e.derooij@amc.uva.nl
Govers
Annerike C
AC
Korevaar
Johanna C
JC
Giesbers
Arja W
AW
Levi
Marcel
M
de Jonge
Evert
E
D000203:Activities of Daily Living / Q000523:psychology*; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D015331:Cohort Studies; D003422:Critical Care / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D011788:Quality of Life / Q000523:psychology*; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative / Q000523:psychology; D017741:Survivors / Q000523:psychology / Q000706:statistics & numerical data