Creation of a dedicated post-intensive care geriatric unit (PIGU), proof of concept and preliminary results

Older patients' admissions to intensive care units (ICUs) are rising worldwide, driven by population aging, and are associated with high rates of mortality and functional decline. Despite expert recommendations for improved care pathways, post-ICU follow-up remains fragmented. This study aimed to evaluate the 3-month survival rate free of functional decline and its associated factors in older post-ICU patients admitted to a dedicated Post-Intensive care Geriatric Unit (PIGU).

This single-center, cohort study included 104 patients aged 75 years or older, admitted to the PIGU at St Antoine Hospital from January 2023 to July 2023 and from January 2025 to July 2025. The primary outcome was survival free of functional decline at 3 months, defined as a loss of more than one point on the ADL score compared to pre-ICU baseline.

The study population comprised 104 patients (52 women, 50%; median age 82 (79-86) years; median ADL 6 (5-6), IADL 4 (2-4), CFS 4 (3-5). The 3-month survival rate free of functional decline was 64%, with 77% of survivors regaining their previous level of autonomy. Lesser ICU-acquired weakness (CPAx score 1.22 [1.05-1.54]) and higher brachial circumference (OR 1.6 [1.12-2.62]) were significantly associated with survival without loss of autonomy.

In this single-center observational study, early geriatric care in a dedicated post-ICU unit was associated with satisfactory 3-month survival free of functional decline and autonomy recovery. These findings support the development of dedicated geriatric programs for older post-ICU patients, though multicenter studies are warranted to confirm these results.