Surgical Intensive Care Should Not Be Restricted for the Elderly

A study has found that elderly patients who survive surgical intensive care perceive their quality of life as high, despite lower functional levels and a slight increase in full dependency. Conducted by researchers at the University of North Carolina at Chapel Hill (USA) and Wake Medical Education Institute (Raleigh, NC, USA), the study was published in the September 2001 issue of the Journal of the American College of Surgeons.

Almost one-third of U.S. health-care resources are consumed by the elderly, making them an easy target for cost-reduction efforts. The current study sought to assess the value of care for elderly survivors of surgical critical illness, using as indicators the activities of daily living and perceived quality of life. The study involved 672 patients, aged 70 and older, who were admitted to a surgical intensive care unit. The researchers integrated information on the intensive care unit, hospital length of stay, admission type and service, and severity of illness with information on preadmission and current activities of daily living in the survivors. The median duration from admission to evaluation was 21 months.

During this time, the activities of daily living scores decreased significantly overall, the proportion of completely independent patients fell from 84.9% to 72%, and the number of completely dependent patients rose from 0% to 3.8%. Nevertheless, perceived quality of life scores were not significantly different from scores in healthy patients living in the community. The researchers concluded that high hospital and post-discharge mortality and the desire to reduce costs should not lead to the restriction of care for elderly patients who require surgical intensive care.




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