title: Critically ill octogenarians and nonagenarians: evaluation of long-term outcomes, posthospital trajectories and quality of life one year and seven years after ICU discharge.
abstract: BACKGROUND
  The aim of this study was to investigate long-term outcomes, posthospital trajectories, and quality of life (QOL) in patients ≥80 years admitted to the Intensive Care Unit (ICU) of a tertiary care hospital.
  
  
  METHODS
  A 1-year prospective observational cohort analysis was performed. All consecutive patients ≥80 years admitted to the ICU were screened for inclusion. Demographics, comorbidity, organ failures, and outcomes were analyzed. QOL before admission, 3 months, 1 year, and 7 years after ICU discharge was assessed using EuroQoL-5D (EQ-5D) and Medical Outcomes Study 36-item Short Form Health Survey (SF-36) questionnaires. Statistical significance was attained at P<0.05.
  
  
  RESULTS
  In the study 131 patients with a median age of 83 years (IQR 81-85), a Charlson Comorbidity Index of 2 (IQR 0-4), a SOFA Score of 4 (3-8) upon ICU admission and an APACHE II Score of 20 (IQR 15-24) were included. ICU, hospital, 3 months, 1-year, and 7-year mortality rates were 17%, 29%, 39%, 50%, and 84% respectively. QOL decreased significantly over time. Most elderly considered QOL as acceptable and perceived only a worsening in physical functioning and self-care at long-term. Of the 1-year and 7-year survivors, 21% and 39% (P=0.122) lived in nursing homes, and 81% and 72% (P=0.423) preferred to be readmitted to an ICU department if necessarily.
  
  
  CONCLUSIONS
  Most critically ill long-term elderly survivors lived at home, perceived their QOL as acceptable, and wanted to be readmitted to the ICU if necessary. In older patients, age alone is a poor indicator of the possible value to be gained from an ICU admission.
authors.affiliation: Department of Intensive Care Medicine, Ghent University Hospital, Ghent, Belgium - sandra.oeyen@ugent.be.|Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium - sandra.oeyen@ugent.be.
authors.forename: Sandra
authors.initials: S
authors.lastname: Oeyen
authors.affiliation: Department of Intensive Care Medicine, Ghent University Hospital, Ghent, Belgium.|Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
authors.forename: Joris
authors.initials: J
authors.lastname: Vermassen
authors.affiliation: Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.|Department of Geriatrics, Ghent University Hospital, Ghent, Belgium.
authors.forename: Ruth
authors.initials: R
authors.lastname: Piers
authors.affiliation: Department of Intensive Care Medicine, Ghent University Hospital, Ghent, Belgium.|Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
authors.forename: Dominique
authors.initials: D
authors.lastname: Benoit
authors.affiliation: I-CHER Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
authors.forename: Lieven
authors.initials: L
authors.lastname: Annemans
authors.affiliation: Department of Intensive Care Medicine, Ghent University Hospital, Ghent, Belgium.|Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
authors.forename: Johan
authors.initials: J
authors.lastname: Decruyenaere
mesh_terms: D000369:Aged, 80 and over; D015331:Cohort Studies; D016638:Critical Illness; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D010351:Patient Discharge; D011446:Prospective Studies; D011788:Quality of Life; D013997:Time Factors