Functional abilities of elderly survivors of intensive care

In a prospective, randomized study undertaken to determine if age, length of hospital stay, or severity of illness are predictors of future functional status after intensive care unit (ICU) admission, 45 patients were evaluated. Pre-ICU functional status was determined by using Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Geriatric Depression Scale (GDS), and Mini-Mental State (MMS) examinations. Severity of illness was assessed by using the Acute Physiology Assessment and Chronic Health Evaluation (APACHE-II) system. There were no significant differences in age or APACHE-II score at 6-month followup. However, in those patients who had decreased ADL and IADL scores, ICU and total hospital length of stay were two and three times longer, respectively. Functional status at 6-months was unrelated to age or severity of illness, but correlated with the length of ICU and total hospital stay. Advanced age and severity of illness should not be used to predict future functional ability.