Functional outcome after critical illness in older patients: a population-based study

Area of Science:

• Gerontology
• Critical Care Medicine
• Neurology

Background:

• Intensive Care Unit (ICU) survivors, particularly older adults, face risks of long-term disability and cognitive decline.
• Understanding factors influencing functional outcomes post-ICU is crucial for improving patient care and rehabilitation strategies.

Purpose of the Study:

• To determine the one-year prevalence of disability among ICU survivors.
• To identify factors associated with functional outcomes and cognitive status after ICU admission in an older population.

Main Methods:

• Analysis of a population-based cohort from the Mayo Clinic Olmsted Study of Aging.
• Inclusion of consecutive adult patients admitted to medical or surgical ICUs between 2006 and 2014.
• Assessment of one-year functional outcomes and cognitive status post-ICU hospitalization.

Main Results:

• Of 831 ICU admissions, 68.5% survived one year. Among survivors, 67.2% achieved good functional outcome.
• Poor one-year functional outcome was linked to female sex, older age, baseline cognitive impairment, higher comorbidity scores, and longer ICU stays.
• Cognitive decline was observed in 32.3% of patients evaluated post-ICU.

Conclusions:

• Two-thirds of older ICU survivors maintained or regained good functional status one year after discharge.
• Older age, female sex, greater comorbidities, baseline cognitive deficits, and prolonged ICU stay predict poor functional recovery.
• Cognitive decline is a common complication following ICU admission in this elderly cohort.