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Related Experiment Videos

Geriatric critical care.

Ramesh Nagappan1, Geoffrey Parkin

  • 1Intensive Care Unit, Monash Medical Centre, 246, Clayton Road, Melbourne, VIC-3168, Australia. ramesh@bigpond.net.au

Critical Care Clinics
|April 18, 2003
PubMed
Summary
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Older age does not predict outcomes for critically ill elderly patients. Severity of illness, not age, is the primary factor influencing survival in intensive care units (ICUs).

Area of Science:

  • Gerontology
  • Critical Care Medicine
  • Health Services Research

Background:

  • Increasing life expectancy leads to a growing population of critically ill elderly patients.
  • Elderly patients consume a disproportionate amount of intensive care unit (ICU) resources and hospital expenditures.
  • Current outcome prediction models for the elderly critically ill are not widely validated, and research is insufficient to guide clinicians.

Purpose of the Study:

  • To examine the role of age in predicting outcomes for critically ill elderly patients.
  • To address the lack of evidence guiding clinical decisions for intensive care of the elderly.
  • To explore factors influencing physician bias and decision-making in the critical care of older adults.

Main Methods:

  • Review of existing literature and outcome prediction models for critically ill elderly patients.

Related Experiment Videos

  • Analysis of factors influencing physician bias in ICU admission and treatment decisions.
  • Discussion of the interplay between severity of illness, age, and patient/physician perceptions of quality of life.

    • Main Results:

    • Age alone is not a predictor of short-term or long-term outcomes in critically ill older patients.
    • Severity of illness is the most significant factor influencing outcomes in critical illness.
    • Physician perceptions of quality of life differ from patient perceptions and influence treatment decisions.

    Conclusions:

    • Clinical decisions for critically ill elderly patients are complex and influenced by ethical, legal, socioeconomic, and personal factors.
    • Age should not be the sole determinant in critical care decisions; severity of illness is paramount.
    • Further research is needed to establish evidence-based guidelines for the critical care of the elderly.