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Intensive Care Medicine
Published in: Intensive Care Medicine 7/2006

01-07-2006 | Original

Decision-making process, outcome, and 1-year quality of life of octogenarians referred for intensive care unit admission

Authors: Maité Garrouste-Orgeas, Jean-François Timsit, Luc Montuclard, Alain Colvez, Olivier Gattolliat, François Philippart, Guillaume Rigal, Benoit Misset, Jean Carlet

Published in: Intensive Care Medicine | Issue 7/2006

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Abstract

Objective

To describe triage decisions and subsequent outcomes in octogenarians referred to an ICU.

Design and setting

Prospective observational study in the medical ICU in a tertiary nonuniversity hospital.

Participants

Cohort of 180 patients aged 80 years or over who were triaged for admission.

Measurements

Age, underlying diseases, admission diagnoses, Mortality Probability Model score, and mortality were recorded. Self-sufficiency (Katz Index of Activities of Daily Living) and quality of life (modified Perceived Quality of Life scale and Nottingham Health Profile) were measured 1 year after triage.

Results

In 132 patients (73.3%) ICU admission was refused, including 79 (43.8%) considered too sick to benefit. Factors independently associated with refusal were nonsurgical status, age older than 85 years, and full unit. Greater self-sufficiency was associated with ICU admission. Hospital mortality was 30/48 (62.5%), 56/79 (70.8%), 9/51 (17.6%), and 0/2 in the admitted, too sick to benefit, too well to benefit, and family/patient refusal groups, respectively; 1-year mortality was 34/48 (70.8%), 69/79 (87.3%), 24/51 (47%), and 0/2, respectively. Self-sufficiency was unchanged by ICU stay. Quality of life (known in only 28 patients) was significantly poorer for isolation, emotional, and mobility domains compared to the French general population matched on sex and age.

Conclusions

More than two-thirds of patients aged over 80 years referred to our ICU were denied admission. One year later self-sufficiency was not modified and quality of life was poorer than in the general population. These results indicate a need to discuss patient preferences before triage decisions.
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Metadata
Title
Decision-making process, outcome, and 1-year quality of life of octogenarians referred for intensive care unit admission
Authors
Maité Garrouste-Orgeas
Jean-François Timsit
Luc Montuclard
Alain Colvez
Olivier Gattolliat
François Philippart
Guillaume Rigal
Benoit Misset
Jean Carlet
Publication date
01-07-2006
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 7/2006
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-006-0169-7

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