Geriatric intensive care--indication and contraindication

The indications for intensive care are discussed on the basis of new statistics assembled by the Swiss Gerontological Society. From the analysis of all admissions to 40 intensive care units (ICU) in Switzerland in 1973, it follows that one third are in the age group 65+, and 11% are 75+ years of age. Nearly 50% of these older patients in ICU had circulatory diseases, compared to 30% in the general population. The ICU of 3 clinics in Nuremberg admitted 38.5% patients over 60 and 18% over 70 years. The 4 main diseases were: myocardial infarction, dysrhythmia, cor pulmonale, and pulmonary embolism. Of 860 patients admitted to the ICU in Berne, 40% were over 64 years, and 17% over 73 years. These were followed for 6 months following discharge, with good results in 64%. It is concluded that old age is no contraindication to intensive care. Diagnosis and therapeutic possibilities, not calendar age, are the basic indication for intensive care. Contraindication is present in cases where after several days in the ICU no satisfactory life can be expected to follow. In acute intoxication only 9-12% were older than 60 years; here intensive care is always indicated.