Research
Quality of life in patients aged 80 or over after ICU discharge
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* Corresponding author: Maité Garrouste-Orgeas mgarrouste@hpsj.fr
1 Medical-Surgical ICU, Saint Joseph Hospital Network, 185 rue Raymond Losserand, 75014 Paris, France
2 Cytokines and inflammation unit, Institut Pasteur, 28 rue du Docteur Roux, 75015 Paris, France
3 INSERM U823 "Epidemiology of cancers and severe diseases", Albert Bonniot Institute, Rond-point de la Chantourne, 38706 La Tronche Cedex
4 Medical Intensive Care Unit, Albert Michallon Teaching Hospital, Joseph Fournier University, BP 217, 38043 Grenoble cedex 09, France
5 Recherche épistémologiques et historiques sur les sciences exactes et les institutions scientifiques (REHSEIS), UMR 7596, Université Paris Diderot, Paris VII, 5 rue Thomas Mann, 75205 Paris Cedex 13, France
6 University Paris Descartes, 12 rue de l'école de médecine, 75005 Paris, France
Critical Care 2010, 14:R2 doi:10.1186/cc8231
See related letter by Koeze and Zijlstra, http://ccforum.com/content/14/4/434
Published: 8 January 2010Abstract
Introduction
Our objective was to describe self-sufficiency and quality of life one year after intensive care unit (ICU) discharge of patients aged 80 years or over.
Methods
We performed a prospective observational study in a medical-surgical ICU in a tertiary non-university hospital. We included patients aged 80 or over at ICU admission in 2005 or 2006 and we recorded age, admission diagnosis, intensity of care, and severity of acute and chronic illnesses, as well as ICU, hospital, and one-year mortality rates. Self-sufficiency (Katz Index of Activities of Daily Living) was assessed at ICU admission and one year after ICU discharge. Quality of life (WHO-QOL OLD and WHO-QOL BREF) was assessed one year after ICU discharge.
Results
Of the 115 consecutive patients aged 80 or over (18.2% of admitted patients), 106 were included. Mean age was 84 ± 3 years (range, 80 to 92). Mortality was 40/106 (37%) at ICU discharge, 48/106 (45.2%) at hospital discharge, and 73/106 (68.9%) one year after ICU discharge. In the 23 patients evaluated after one year, self-sufficiency was unchanged compared to the pre-admission status. Quality of life evaluations after one year showed that physical health, sensory abilities, self-sufficiency, and social participation had slightly worse ratings than the other domains, whereas social relationships, environment, and fear of death and dying had the best ratings. Compared to an age- and sex-matched sample of the general population, our cohort had better ratings for psychological health, social relationships, and environment, less fear of death and dying, better expectations about past, present, and future activities and better intimacy (friendship and love).
Conclusions
Among patients aged 80 or over who were selected at ICU admission, 80% were self-sufficient for activities of daily living one year after ICU discharge, 31% were alive, with no change in self-sufficiency and with similar quality of life to that of the general population matched on age and sex. However, these results must be interpreted cautiously due to the small sample of survivors.