Critically ill octogenarians and nonagenarians : evaluation of long-term outcomes, post-hospital trajectories and quality of life one year and seven years after ICU discharge

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. RESULT: 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. (Cite this article as: Oeyen S, Vermassen J, Piers R, Benoit D, Annemans L, Decruyenaere J. Critically ill octogenarians and nonagenarians: evaluation of long-term outcomes, posthospital trajectories and quality of life one year and seven years after ICU discharge.