title: The status of intensive care medicine research and a future agenda for very old patients in the ICU.
abstract: The "very old intensive care patients" (abbreviated to VOPs; greater than 80 years old) are probably the fastest expanding subgroup of all intensive care unit (ICU) patients. Up until recently most ICU physicians have been reluctant to admit these VOPs. The general consensus was that there was little survival to gain and the incremental life expectancy of ICU admission was considered too small. Several publications have questioned this belief, but others have confirmed the poor long-term mortality rates in VOPs. More appropriate triage (resource limitation enforced decisions), admission decisions based on shared decision-making and improved prediction models are also needed for this particular patient group. Here, an expert panel proposes a research agenda for VOPs for the coming years.
authors.affiliation: Department of Clinical Medicine, ICU, Haukeland University Hospital, University of Bergen, Bergen, Norway. Hans.Flaatten@uib.no.|Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway. Hans.Flaatten@uib.no.
authors.forename: H
authors.identifier: http://orcid.org/0000-0001-9186-3482
authors.initials: H
authors.lastname: Flaatten
authors.affiliation: Department of Intensive Care Medicine, University Medical Center, Utrecht, The Netherlands.
authors.forename: D W
authors.initials: DW
authors.lastname: de Lange
authors.affiliation: Department of Intensive Care Medicine, CIBER Enfermedades Respiratorias, Corporacion Sanitaria Universitaria Parc Tauli, Autonomous University of Barcelona, Sabadell, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Artigas
authors.affiliation: Medical ICU, Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing, 100730, China.
authors.forename: D
authors.initials: D
authors.lastname: Bin
authors.affiliation: Unidade de Cuidados Intensivos Neurocríticos, Hospital de São José, Centro Hospitalar de Lisboa Central, Lisbon, Portugal.
authors.forename: R
authors.initials: R
authors.lastname: Moreno
authors.affiliation: Department of Anaesthesia and Intensive Care Medicine, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: S
authors.initials: S
authors.lastname: Christensen
authors.affiliation: Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong and School of Medicine, Royal Brisbane Clinical School, The University of Queensland, Queensland, Australia.
authors.forename: G M
authors.initials: GM
authors.lastname: Joynt
authors.affiliation: Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
authors.forename: Sean M
authors.initials: SM
authors.lastname: Bagshaw
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: C L
authors.initials: CL
authors.lastname: Sprung
authors.affiliation: Department of Intensive Care, Ghent University Hospital, de pintelaan 185, 2K12IC, Ghent, Belgium.
authors.forename: D
authors.initials: D
authors.lastname: Benoit
authors.affiliation: Department of Critical Care, D'Or Institute for Research and Education, Rio De Janeiro, Brazil.
authors.forename: M
authors.initials: M
authors.lastname: Soares
authors.affiliation: Assistance Publique, Hôpitaux de Paris, Hôpital Saint-Antoine, Service de Réanimation Médicale, 75012, Paris, France.|Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 75013, Paris, France.|INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 75013, Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Guidet
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D035843:Biomedical Research; D060825:Cognitive Dysfunction / Q000150:complications; D003422:Critical Care / Q000458:organization & administration; D016021:Epidemiologic Studies; D000073496:Frailty / Q000150:complications; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000592:standards / Q000706:statistics & numerical data*; D007902:Length of Stay; D010043:Outcome and Process Assessment, Health Care; D010343:Patient Admission / Q000706:statistics & numerical data*; D011788:Quality of Life; D012720:Severity of Illness Index; D014218:Triage / Q000379:methods
keywords: Elderly; Frailty; ICU; Mortality; Octogenarians; Severity of illness