scholarly journals Characteristics of Critically Ill Elderly Patients Admitted to a Tertiary Intensive Care Unit in Nigeria and Outcome of Management

2017 ◽  
Vol 2 (5) ◽  
Author(s):  
Tobi KU ◽  
Ndokwu EO ◽  
Edomwonyi NP
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Elderly Patients ◽  
Critically Ill

Admission of the very elderly to the intensive care unit: Family members’ perspectives on clinical decision-making from a multicenter cohort study

2015 ◽  
Vol 29 (4) ◽  
pp. 324-335 ◽  
Author(s):  
Daren K Heyland ◽  
Peter Dodek ◽  
Sangeeta Mehta ◽  
Deborah Cook ◽  
Allan Garland ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Cohort Study ◽  
Intensive Care ◽  
Elderly Patients ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Clinical Decision Making ◽  
Family Members ◽  
Very Elderly

Background: Little is known about the perspectives and experiences of family members of very elderly patients who are admitted to the intensive care unit. Aim: To describe family members’ perspectives about care provided to very elderly critically ill patients. Design: Multicenter, prospective, cohort study. Participants and setting: In total, 535 family members of patients aged 80 years or older admitted to 22 intensive care units for more than 24 h. Results: Family members reported that the “patient be comfortable and suffer as little as possible” was their most important value and “the belief that life should be preserved at all costs” was their least important value considered in making treatment decisions. Most family members (57.9%) preferred that life support be used for their family member, whereas 24.1% preferred comfort measures only, and 14.4% were unsure of their treatment preferences. Only 57.3% reported that a doctor had talked to them about treatment options for the patient. Overall, 29.7% of patients received life-sustaining treatments for more than 7 days and 50.3% of these died in hospital. Families were most satisfied with the skill and competency of nurses and least satisfied with being included and supported in the decision-making process and with their sense of control over the patient’s care. Conclusion: There is incongruity between family values and preferences for end-of-life care and actual care received for very elderly patients who are admitted to the intensive care unit. Deficiencies in communication and decision-making may be associated with prolonged use of life-sustaining treatments in very elderly critically ill patients, many of whom ultimately die.

scholarly journals Effect of Systematic Intensive Care Unit Triage on Long-term Mortality Among Critically Ill Elderly Patients in France

JAMA ◽  
2017 ◽  
Vol 318 (15) ◽  
pp. 1450 ◽  
Author(s):  
Bertrand Guidet ◽  
Guillaume Leblanc ◽  
Tabassome Simon ◽  
Maguy Woimant ◽  
Jean-Pierre Quenot ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Elderly Patients ◽  
Critically Ill ◽  
Long Term Mortality

Prognostic factors associated with adverse outcome among critically ill elderly patients admitted to the intensive care unit

2014 ◽  
Vol 15 (7) ◽  
pp. 889-894 ◽  
Author(s):  
Jose Orsini ◽  
Ashvin Butala ◽  
Say Salomon ◽  
Sean Studer ◽  
Shardul Gadhia ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Prognostic Factors ◽  
Elderly Patients ◽  
Critically Ill ◽  
Adverse Outcome ◽  
Factors Associated

Randomized Trial of an Intensive Care Unit–Based Early Discharge Planning Intervention for Critically Ill Elderly Patients

2004 ◽  
Vol 13 (4) ◽  
pp. 335-345 ◽  
Author(s):  
Ruth M. Kleinpell
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Elderly Patients ◽  
Critically Ill ◽  
Discharge Planning ◽  
Severity Of Illness ◽  
Early Discharge ◽  
Control Group ◽  
Experimental Group ◽  
At Home

• Background Few investigators have targeted elderly patients and monitored outcomes of care in studies on discharge planning interventions after critical illness. • Objectives To pilot test an intensive care unit–based nursing screening intervention to assist in determining the discharge needs and outcomes of critically ill elderly patients. • Method A randomized clinical trial with in-hospital and mailed questionnaires was used. Patients 65 years and older who were hospitalized in 1 of 2 intensive care units at 2 midwestern university-affiliated medical centers were recruited for the study. Control patients (n = 53) received usual discharge planning; experimental patients (n = 47) were screened in the intensive care unit by using the Discharge Planning Questionnaire. Both groups were assessed for readiness for discharge when discharged from the hospital and were followed up 2 weeks later with a survey completed at home. • Results One hundred patients 65 to 90 years old (mean 73, SD 5.78) completed the study. Sixty-six percent were men. The 2 groups did not differ with regard to age, race, sex, severity of illness, lengths of stay in the intensive care unit or hospital, education level, or income. Patients in the experimental group were more ready than patients in the control group for discharge (P = .06). Patients in the experimental group were also more likely to report they had adequate information, had less concern about managing their care at home, knew their medicines, and knew danger signals indicating potential complications. • Conclusion Intensive care unit–based early discharge planning can affect elderly patients’ preparation for discharge.

scholarly journals Prediction of mortality in critically-ill elderly trauma patients: a single centre retrospective observational study and comparison of the performance of trauma scores

2020 ◽  
Vol 28 (1) ◽  
Author(s):  
Rebecca Egglestone ◽  
David Sparkes ◽  
Ahilanandan Dushianthan
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Elderly Patients ◽  
Critically Ill ◽  
Scoring Systems ◽  
Trauma Patients ◽  
Prediction Of Mortality ◽  
Major Trauma Centre ◽  
Significant Difference ◽  
Elderly Trauma Patients

Abstract Background Trauma in the elderly (≥ 65 years) population is increasing. This study compares the performance of trauma scoring systems in predicting 30-day mortality among the traumatised elderly patients admitted to the intensive care unit in a major trauma centre. Methods We collected retrospective data for all elderly trauma patients admitted to our intensive care units between January 2012 and December 2017. We assessed Injury Severity Score (ISS), Geriatric Trauma Outcome Score (GTOS) and the Trauma Audit and Research Network’s (TARN) Probability of Survival (Ps17) between survivors and non-survivors. Receiver operator characteristic (ROC) curves were used to assess the performance of these scoring systems. Results There were 255 elderly trauma patients with overall 30-day survival of 76%. There was a statistically significant difference in ISS, GTOS and Ps17 scores between survivors and non-survivors (p < 0.001). The area under the ROC curve (AUROC) was statistically significant for all 3, with AUROC of 0.66 (95% CI 0.59–0.74) for the ISS, 0.68 (95% CI 0.61–0.76) for the GTOS and 0.79 (95% CI 0.72–0.85) for the Ps17. The optimal cut-off points were ≥ 28, ≥ 142, ≤ 76.73 for ISS, GTOS and Ps17, respectively. Conclusion Both ISS and GTOS scoring systems preformed equally in predicting 30-day mortality in traumatised elderly patients admitted to the intensive care unit, however neither were robust enough to utilise in clinical practise. The Ps17 performed more robustly, although was not developed for prognosticating on individual patients. Larger prospective studies are needed to validate these scoring systems in critically-ill elderly traumatised patients, which may help to facilitate early prognostication.

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