Valentin A
Abteilung für Innere Medizin, Kardinal Schwarzenberg Klinikum, Kardinal-Schwarzenberg-Straße 2-6, 5620, Schwarzach im Pongau, Österreich.
Med Klin Intensivmed Notfmed. 2017 May;112(4):303-307. doi: 10.1007/s00063-017-0281-1. Epub 2017 Apr 24.
The increasing aging of the population in highly developed countries poses a profound impact on intensive care services. This is illustrated by a finding from a large Austrian database showing that 20% of all intensive care patients are aged ≥80 years. Age per se is not an exclusion criteria for admission to the intensive care unit, but older patients are frequently affected by multiple comorbidities and experience a decreased physiologic reserve. Due to the very heterogeneous population of aged patients and since no generally accepted criteria for admission and treatment of these patients exist, any treatment decision must be made taking into consideration the individual situation. The perspective after possible survival from a critical illness is considered as the most important outcome and goes far beyond the question of survival alone. Many old patients have the chance to return to an acceptable quality of life even after a life-threatening illness. However, with respect to the limitations of human life, it is not justified to start or prolong intensive care in elderly patients without a reasonable possibility of a benefit, which is not soley defined in terms of survival.
高度发达国家人口老龄化加剧对重症监护服务产生了深远影响。奥地利一个大型数据库的一项研究结果表明，所有重症监护患者中有20%的年龄≥80岁，这说明了这一点。年龄本身并非重症监护病房收治的排除标准，但老年患者常受多种合并症影响，生理储备能力下降。由于老年患者群体非常多样化，且目前尚无针对这些患者的普遍接受的收治和治疗标准，因此任何治疗决策都必须考虑个体情况。危重病后可能存活的前景被视为最重要的结果，远不止单纯的生存问题。许多老年患者即使在经历危及生命的疾病后，仍有机会恢复到可接受的生活质量。然而，考虑到人类生命的局限性，在老年患者中启动或延长重症监护而没有合理的获益可能性（获益不仅仅以生存来定义）是不合理的。
