Outcome of respiratory intensive care for the elderly

We followed 1018 patients admitted consecutively to a multidisciplinary respiratory ICU (RICU), with special attention to patients aged 75 yr and over. The elderly had a higher RICU (11/49) and in-hospital (21/49) mortality than younger patients. The 28 survivors of hospitalization had a lower acute physiology score (APS) than nonsurvivors on admission (16.1 +/- 7.8 vs. 21.8 +/- 8.9, respectively), indicating less severe illness. The quality of long-term survival (12 to 24 months) was assessed using an open-ended questionnaire. Eighteen hospital survivors were alive at the time of follow-up and the quality of life was deemed satisfactory by 10 of 13 patients who were living independently. Only two of 28 survivors had been transferred to nursing home care, and two were in acute care hospitals. We conclude most elderly patients discharged from the RICU consider their lifestyle satisfactory and are not a large drain on community health care resources. Further studies of the screening process which determines RICU admission are necessary, because unimodal criteria such as age and APS after admission were not of prognostic value.