Boumendil Ariane, Somme Dominique, Garrouste-Orgeas Maïté, Guidet Bertrand
Faculté de médecine St Antoine, INSERM, U707, 27 rue de Chaligny, 75012, Paris, France.
Université Pierre et Marie Curie, Paris 6, UMR S U707, 75012, Paris, France.
Intensive Care Med. 2007 Jul;33(7):1252. doi: 10.1007/s00134-007-0621-3. Epub 2007 Apr 3.
As the general population ages, an increasing number of patients over 80 years are being admitted to the intensive care unit (ICU). Selection of older patients for ICU admission results in lower rates of co-morbidities and underlying fatal diseases. After adjustment for disease severity, ICU and post-ICU mortality rates are higher in elderly patients than in younger populations. Age itself explains only a small part of the increased hospital mortality, suggesting that specific information such as functional, cognitive, and nutritional status, as well as co-morbidities, should be collected to predict mortality in elderly ICU patients. The long-term prognosis depends chiefly on functional status, whereas initial disease severity no longer influences mortality. According to our review, it is impossible to define evidence-based recommendations for ICU admission of the elderly. This justifies further studies that encompass several aspects, such as the initial triage process and the long-term prognosis (mortality, autonomy and quality of life).
随着普通人群老龄化，越来越多80岁以上的患者被收入重症监护病房（ICU）。选择老年患者入住ICU会降低合并症和潜在致命疾病的发生率。在对疾病严重程度进行调整后，老年患者在ICU及ICU后的死亡率高于年轻人群。年龄本身仅能解释医院死亡率增加的一小部分原因，这表明应收集诸如功能、认知和营养状况以及合并症等特定信息，以预测老年ICU患者的死亡率。长期预后主要取决于功能状态，而初始疾病严重程度不再影响死亡率。根据我们的综述，无法为老年患者入住ICU制定基于证据的建议。这证明有必要进行涵盖多个方面的进一步研究，例如初始分诊过程和长期预后（死亡率、自主性和生活质量）。
