Evaluation of long-term outcomes of very old patients admitted to intensive care: Survival, functional status, quality of life, and quality-adjusted life-years

Abstract Purpose To evaluate long-term outcomes among a population of very old patients (≥ 80 years) after nonelective intensive care unit (ICU) admission. Methods A retrospective study of very old patients admitted to a mixed ICU between 2006 and 2012 was conducted. A detailed description was made; functional status was assessed through the modified Rankin Scale and quality of life through EQ-5D-3L. Follow-up results are compared between 3 groups: very old with “old” (66-79 years) and “non-old” (≤ 65 years) patients. Results A total of 278 very old patients were admitted into the ICU representing 10.3% of admissions. The mean (SD) Simplified Acute Physiology Score II was 61 (16) predicting a hospital mortality of 70%, and the observed hospital mortality was 53%. Two-year survival rate was 38%. Of the 158 patients who survived in the ICU, 51 were evaluated in the outpatient clinic, and of those, 25 (51%) had already resumed previous functional activity. Evaluation through the modified Rankin Scale showed that 29 (60%) remained independent in their daily activities. When comparing the 3 groups, several differences were observed between theme, with the oldest groups (> 80 years) reporting more problems in motility, self-care, and usual activities. The respondent's self-rated health through the median visual analog scale score on the day of the outpatient clinic appointment decreased with age. Conclusions For those who survive, return to previous functional activity was likely. Long-term survival and quality of life achieved afterward were translated in more than a year of perfect health status gained.