Short-and long-term health implications of surgical intensive care in the elderly

Stefan Utzolino, Philipp A Ober, Magnus Kaffarnik, Andreas Fischer, Ulrich T Hopt, Peter K Baier

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DOI: 10.4236/health.2010.212209                

Abstract

Background: Treatment of elderly patients on intensive care units is an increasing challenge all over the world. Objectives: To evaluate short- term survival and long-term quality of life im-plications of intensive care for the elderly. Methods: Retrospective analysis of 314 patients 75 years of age or more requiring over 48 hours of intensive care. Results: In multivariate analy-sis, significant risk factors for mortality were chronic renal impairment (OR for survival .30, p < 0.001) and chronic obstructive pulmonary disease (OR 0.48, p = 0.003), pneumonia (OR for non-surviving 3.01, p < 0.001), or thrombosis (OR 1.89, p = 0.003); sepsis was not (OR 1.96, p = 0.055). Therapeutic measures associated with mortality were ventilator therapy > 24 h (OR 4.5), hemodialysis (OR 6.8), and vasopressor therapy (OR 2.5, p < 0.001 for each). A health survey questionnaire in an up to 60-month follow-up of 28 patients revealed considerably lower physi-cal subscores of our patients compared to the general elderly population. Conclusions: Elderly patients benefit from intensive care in terms of survival. Complications are frequent, as are severe consequences for long-term quality of life. Short-term mortality in elderly intensive care patients correlates most closely to pre- existing disease, not age.

Keywords

Surgical Intensive Care; Aged; Frail Elderly; Quality of Life; General Surgery; Concomitant Disease

Conflicts of Interest

The authors declare no conflicts of interest.

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