title: The impact of intensive care in a private hospital on patients aged 80 and over: health-related quality of life, functional status and burden versus benefit.
abstract: BACKGROUND
  Greater numbers of persons aged over 80 years are admitted to intensive care units (ICU) compared with 15 years ago. Outcomes other than death such as physical dependence and cognitive impairment and treatment burden are important to older people.
  
  
  OBJECTIVE
  The aims of this study were to determine the long-term outcomes of functional impairment, health-related quality of life (HRQoL) and the self-reported burden of treatment in a sample of patients aged 80 years and above admitted to ICU. Half of the cohort were admitted for elective cardiac surgery, the rest for non-cardiac surgery and medical conditions.
  
  
  METHODS
  In this longitudinal cohort study, in a tertiary level ICU, we measured HRQoL using the SF-36 and functional status using the modified Barthel Index at several time points over a 2-year follow-up period. We also assessed treatment burden by asking participants whether they thought the episode of care was worthwhile.
  
  
  RESULTS
  A total of 348 patients was recruited into the study. One-fifth of the cohort had died by the 2-year follow-up data collection point. There was an improvement in physical functioning in the cardiac surgery group at 6 months which was not sustained. There was no change in HRQoL at 2 years in either group. The majority valued the episode of care.
  
  
  CONCLUSIONS
  We demonstrated that HRQoL and previous lifestyle is preserved in the majority following ICU admission, associated with a high level of patient valuation of the episode of care.
authors.affiliation: Department of Medicine, Cabrini-Monash University, Cabrini Institute for Research and Education, Melbourne, Victoria, Australia.|Monash University, Melbourne, Victoria, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Levinson
authors.affiliation: Department of Medicine, Cabrini-Monash University, Cabrini Institute for Research and Education, Melbourne, Victoria, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Mills
authors.affiliation: Monash Centre for Health Research and Implementation, Melbourne, Victoria, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Oldroyd
authors.affiliation: Department of Medicine, Cabrini-Monash University, Cabrini Institute for Research and Education, Melbourne, Victoria, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Gellie
authors.affiliation: Intensive Care Unit, Cabrini Health, Melbourne, Victoria, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Barrett
authors.affiliation: Cabrini Institute for Research and Education, Melbourne, Victoria, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Staples
authors.affiliation: Department of Medicine, Cabrini-Monash University, Cabrini Institute for Research and Education, Melbourne, Victoria, Australia.
authors.forename: G
authors.initials: G
authors.lastname: Stephenson
mesh_terms: D000369:Aged, 80 and over; D001315:Australia; D002908:Chronic Disease / Q000401:mortality*; D015897:Comorbidity; D017281:Cost of Illness; D003422:Critical Care / Q000592:standards*; D005260:Female; D006304:Health Status; D016304:Hospitals, Private; D006801:Humans; D007362:Intensive Care Units; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D063868:Patient Outcome Assessment; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
keywords: cardiovascular clinical research; chronic disease; intensive care; long-term outcome assessment; older adults; quality of life