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Intensive Care Med. 2017 Sep;43(9):1319-1328. doi: 10.1007/s00134-017-4718-z. Epub 2017 Feb 25.

The status of intensive care medicine research and a future agenda for very old patients in the ICU.

Author information

1
Department of Clinical Medicine, ICU, Haukeland University Hospital, University of Bergen, Bergen, Norway. Hans.Flaatten@uib.no.
2
Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway. Hans.Flaatten@uib.no.
3
Department of Intensive Care Medicine, University Medical Center, Utrecht, The Netherlands.
4
Department of Intensive Care Medicine, CIBER Enfermedades Respiratorias, Corporacion Sanitaria Universitaria Parc Tauli, Autonomous University of Barcelona, Sabadell, Spain.
5
Medical ICU, Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing, 100730, China.
6
Unidade de Cuidados Intensivos Neurocríticos, Hospital de São José, Centro Hospitalar de Lisboa Central, Lisbon, Portugal.
7
Department of Anaesthesia and Intensive Care Medicine, Aarhus University Hospital, Aarhus, Denmark.
8
Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong and School of Medicine, Royal Brisbane Clinical School, The University of Queensland, Queensland, Australia.
9
Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
10
Department of Anesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
11
Department of Intensive Care, Ghent University Hospital, de pintelaan 185, 2K12IC, Ghent, Belgium.
12
Department of Critical Care, D'Or Institute for Research and Education, Rio De Janeiro, Brazil.
13
Assistance Publique, Hôpitaux de Paris, Hôpital Saint-Antoine, Service de Réanimation Médicale, 75012, Paris, France.
14
Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 75013, Paris, France.
15
INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 75013, Paris, France.

Abstract

The "very old intensive care patients" (abbreviated to VOPs; greater than 80 years old) are probably the fastest expanding subgroup of all intensive care unit (ICU) patients. Up until recently most ICU physicians have been reluctant to admit these VOPs. The general consensus was that there was little survival to gain and the incremental life expectancy of ICU admission was considered too small. Several publications have questioned this belief, but others have confirmed the poor long-term mortality rates in VOPs. More appropriate triage (resource limitation enforced decisions), admission decisions based on shared decision-making and improved prediction models are also needed for this particular patient group. Here, an expert panel proposes a research agenda for VOPs for the coming years.

KEYWORDS:

Elderly; Frailty; ICU; Mortality; Octogenarians; Severity of illness

PMID:
28238055
DOI:
10.1007/s00134-017-4718-z
[Indexed for MEDLINE]

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