[Priorisation of old critically-ill patients for an ICU admission]

PRIORISATION OF OLD CRITICALLY-ILL PATIENTS FOR AN ICU ADMISSION There are currently no national or international recommendations for admission decisions to an intensive care unit (icu) for patients over 80 years of age. The decision, whether, or not to admit an elderly patient to intensive care is probably one of the most difficult decisions for an intensivist with the double risk of loss of chance in the event of refusal or non-beneficial care in the event of acceptance. Doubt should always benefit the patient with icu admission in case of prognosis uncertainty. In that case the patient should be reassessed after a few days for tailoring of the level of care. The best criterion for judging the accuracy of decisions is the vital but also the functional prognosis and the long-term expected quality of life for the patient and his relatives. Current and future demographic changes as well as financial constraints justify producing general guidelines in order to ease the decision-making process and reduce practice heterogeneity. The principle of distributive justice must apply in situations of strain on icu bed availability, as in times of a Covid wave.