Charpentier A, Garnier M, Deschasse G, Vandenberghe W, Beuscart J B, Visade F
Department of Geriatrics, CHU Lille, Lille, France.
Department of Geriatrics, Lille Catholic Hospitals, Lille, France.
Eur Geriatr Med. 2025 Feb;16(1):363-371. doi: 10.1007/s41999-024-01108-5. Epub 2024 Nov 27.
The benefits of intensive care (in terms of the maintenance of functional independence and a reduction in the mortality rate in older patients) are still subject to debate, and the value of geriatric care of older adults discharged from an intensive care unit (ICU) has not been extensively studied. The objective of the present study was to examine the 1-year trajectory of patients transferred from an ICU to an acute geriatric unit (AGU).
We conducted an ambispective, descriptive, single-center study of older adults aged 75 and over from the DAMAGE cohort and having been transferred from an ICU to an AGU. The outcomes (functional independence, according to the Katz Activities of Daily Living (ADL) scale, place of living, and mortality) were documented on discharge from the AGU and 3 and 12 months thereafter.
Of the 3,500 older adults in the DAMAGE cohort, 130 patients had been admitted to an ICU and transferred to an AGU. Before hospitalization, the median ADL score was 5 out of 6 (interquartile range [IQR] 4-6), with a majority of people living at home (n = 106, 82%). On discharge from the AGU, 113 patients were alive and had a median ADL score of 4 (IQR [2-5]). Fifty-nine patients (52.2%) were discharged to home. At 3 months and 12 months post-discharge, respectively, 97 (85.8%) and 79 (69.9%) patients were still alive and were functionally independent (median ADL scores: 4.5 (IQR [4; 5.5] and 5 (IQR [4-6])); 75 (66.4%) and 57 (50.4%) were still living at home.
Our results show that many older adults transferred from ICU to an AGU maintain their functional independence, which enables them to be discharged to home and remain there for at least the following year. Further research should address the detection of geriatric syndromes at an early stage and the identification of patients who could benefit from the ICU-AGU trajectory.
重症监护的益处（就维持功能独立性和降低老年患者死亡率而言）仍存在争议，且对于从重症监护病房（ICU）出院的老年人的老年护理价值尚未进行广泛研究。本研究的目的是调查从ICU转至急性老年病科（AGU）的患者的1年病程。
我们对DAMAGE队列中年龄在75岁及以上且已从ICU转至AGU的老年人进行了一项回顾性、描述性、单中心研究。在从AGU出院时以及此后3个月和12个月记录结局（根据Katz日常生活活动（ADL）量表评估的功能独立性、居住地点和死亡率）。
在DAMAGE队列的3500名老年人中，130例患者入住过ICU并转至AGU。入院前，ADL评分中位数为6分中的5分（四分位间距[IQR]4 - 6），大多数人居家生活（n = 106，82%）。从AGU出院时，113例患者存活，ADL评分中位数为4分（IQR[2 - 5]）。59例患者（52.2%）出院回家。出院后3个月和12个月时，分别有97例（85.8%）和79例（69.9%）患者仍存活且功能独立（ADL评分中位数：4.5（IQR[4；5.5]）和5（IQR[4 - 6]））；75例（66.4%）和57例（50.4%）仍居家生活。
我们的结果表明，许多从ICU转至AGU的老年人维持了其功能独立性，这使他们能够出院回家并至少在接下来的一年里保持在家中。进一步的研究应关注老年综合征的早期检测以及确定哪些患者可从ICU - AGU病程中获益。
