Home return 6 months after an intensive care unit admission for elderly patients

Home return after critical care is very important not only to patients and families. To move back home, patients have to fulfill two conditions: survive, and have a relatively good functional status. In addition, home return could be considered a low-cost outcome because of the reduced permanent healthcare costs.

To determine the factors influencing the home-return probability of critically ill elderly patients 6 months after an intensive care unit (ICU) admission, we analyzed a cohort of patients aged 65 years or older admitted to an ICU. Demographic and social parameters, as well as admission diagnosis, underlying diseases, severity scores, ICU stay parameters, and complications were recorded. The final outcome was the place of stay (or death) 180 days after ICU admission.

Of 526 patients, 72% of the cohort and 93% of hospital survivors were able to return to their homes. Among the variables used in the multivariate logistic regression, advanced age, length of hospital stay before ICU admission, severity of acute illness, diagnosis category, and complications, as well as certain comorbidities, such as chronic heart failure or a neoplasia, were independently negatively associated with a home return.

Some interesting factors were identified in this single-center study. They could be considered for a multicenter study to build a universal prediction model for home return. Home return could be used for elderly patients as a surrogate for outcomes that are very important to the elderly but also to health politics.