title: Transitions experienced by older survivors of critical care.
abstract: The transition from hospital to home is complicated for older adults who experience a serious or life-threatening illness. The specific aims of this prospective, observational cohort study were to determine the number of older adults who experience a change in their functional ability and residence after an intensive care unit (ICU) stay and to explore risk factors for functional decline and new institutionalization at hospital discharge. We found high rates of unrecognized preexisting cognitive impairment, delirium, complications, functional decline, and new institutionalization in this sample (N = 43). A number of variables were associated with functional decline or new institutionalization, including narcotic agent use (p = 0.03), ICU complications (p = 0.05), comorbidities (p = 0.01), depression (p = 0.05), and severity of illness (p = 0.05). We identified device self-removal, admission type, and ICU delirium as also potentially associated with these outcomes (p ≤ 0.25). There are a number of important and potentially modifiable factors that influence an older adult's ability to recover after a critical illness.
authors.affiliation: College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA. mbalas@unmc.edu
authors.forename: Michele C
authors.initials: MC
authors.lastname: Balas
authors.forename: Claudia
authors.initials: C
authors.lastname: Chaperon
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Sisson
authors.forename: Steven
authors.initials: S
authors.lastname: Bonasera
authors.forename: Melody
authors.initials: M
authors.lastname: Hertzog
authors.forename: Jane
authors.initials: J
authors.lastname: Potter
authors.forename: Delayne
authors.initials: D
authors.lastname: Peterson
authors.forename: Wendy
authors.initials: W
authors.lastname: McVay
authors.forename: Jackie
authors.initials: J
authors.lastname: Gorman
authors.forename: William J
authors.initials: WJ
authors.lastname: Burke
mesh_terms: D000368:Aged; D003422:Critical Care; D004496:Education, Continuing; D005260:Female; D006801:Humans; D008297:Male; D017741:Survivors