The impact of age-related syndromes on ICU process and outcomes in very old patients
Vallet, Hélène; Guidet, Bertrand; Boumendil, Ariane; De Lange, Dylan W.; Leaver, Susannah; Szczeklik, Wojciech; Jung, Christian; Sviri, Sigal; Beil, Michael; Flaatten, Hans Kristian
Journal article, Peer reviewed
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Date
2023Metadata
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- Department of Clinical Medicine [2086]
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Abstract
In this narrative review, we describe the most important age-related “syndromes” found in the old ICU patients. The syndromes are frailty, comorbidity, cognitive decline, malnutrition, sarcopenia, loss of functional autonomy, immunosenescence and inflam-ageing. The underlying geriatric condition, together with the admission diagnosis and the acute severity contribute to the short-term, but also to the long-term prognosis. Besides mortality, functional status and quality of life are major outcome variables. The geriatric assessment is a key tool for long-term qualitative outcome, while immediate severity accounts for acute mortality. A poor functional baseline reduces the chances of a successful outcome following ICU. This review emphasises the importance of using a geriatric assessment and considering the older patient as a whole, rather than the acute illness in isolation, when making decisions regarding intensive care treatment.