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Functional Status and Quality of Life in Elderly Intensive Care Unit Survivors.
J Am Geriatr Soc. 2016 Mar; 64(3):536-42.JA

Abstract

OBJECTIVES

To evaluate functional status and quality of life in elderly intensive care unit (ICU) survivors at 1-year follow-up.

DESIGN

Prospective 18-month observational study.

SETTING

University medical-surgical ICU.

PARTICIPANTS

ICU survivors aged 75 and older.

MEASUREMENTS

Functional status at baseline (Barthel Index (BI)) was compared with that at hospital discharge and 1-year follow-up. Health-related quality of life (HRQL Spanish version of the Medical Outcomes Study 36-item Short-From Survey) was measured at 1-year follow-up and compared with that of the Spanish population of same age.

RESULTS

Of 176 individuals admitted to the ICU, 110 (62.1%) were discharged alive from the hospital, and 94 (53.1%) were alive at 1-year follow-up. ICU admission was associated with significant clinical deterioration (median BI 100 points (interquartile range (IQR) 85-100) at baseline vs 85 (IQR 60-100) at hospital discharge, P < .001). Three months after discharge, there was a significant although modest improvement in functional status (BI 95 (IQR 80-100) P = .03). Baseline functional status was not recovered at 1-year follow-up (BI 95 (IQR 80-100) P < .001). More ICU survivors had moderate to severe dependence at the end of follow-up (20.3%) than at ICU admission (6.6%) (P < .001). Factors independently associated with poor functional recovery were low baseline BI and ICU stay longer than 4 days. At 1-year follow-up, 76.8% of participants who survived were living in their own homes. HRQL was similar to that of the Spanish population of the same age.

CONCLUSION

Elderly ICU survivors experienced significant deterioration in functional status, and although they recovered modestly during the following year, they never regained their baseline status. Good recovery was associated with short ICU stay and better baseline functional status.

Authors+Show Affiliations

Intensive Care Unit, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain.Intensive Care Unit, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain.Intensive Care Unit, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain.Palliative Care Unit, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain.Intensive Care Unit, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain.Intensive Care Unit, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain.Section of Intensive Care Medicine, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain.Intensive Care Unit, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain. Department of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

27000326

Citation

Villa, Patricia, et al. "Functional Status and Quality of Life in Elderly Intensive Care Unit Survivors." Journal of the American Geriatrics Society, vol. 64, no. 3, 2016, pp. 536-42.
Villa P, Pintado MC, Luján J, et al. Functional Status and Quality of Life in Elderly Intensive Care Unit Survivors. J Am Geriatr Soc. 2016;64(3):536-42.
Villa, P., Pintado, M. C., Luján, J., González-García, N., Trascasa, M., Molina, R., Cambronero, J. A., & de Pablo, R. (2016). Functional Status and Quality of Life in Elderly Intensive Care Unit Survivors. Journal of the American Geriatrics Society, 64(3), 536-42. https://doi.org/10.1111/jgs.14031
Villa P, et al. Functional Status and Quality of Life in Elderly Intensive Care Unit Survivors. J Am Geriatr Soc. 2016;64(3):536-42. PubMed PMID: 27000326.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Functional Status and Quality of Life in Elderly Intensive Care Unit Survivors. AU - Villa,Patricia, AU - Pintado,María-Consuelo, AU - Luján,Jimena, AU - González-García,Natalia, AU - Trascasa,María, AU - Molina,Rocío, AU - Cambronero,José-Andrés, AU - de Pablo,Raúl, PY - 2016/3/23/entrez PY - 2016/3/24/pubmed PY - 2016/8/4/medline KW - activities of daily living KW - aged KW - critical care KW - outcome assessment KW - quality of life SP - 536 EP - 42 JF - Journal of the American Geriatrics Society JO - J Am Geriatr Soc VL - 64 IS - 3 N2 - OBJECTIVES: To evaluate functional status and quality of life in elderly intensive care unit (ICU) survivors at 1-year follow-up. DESIGN: Prospective 18-month observational study. SETTING: University medical-surgical ICU. PARTICIPANTS: ICU survivors aged 75 and older. MEASUREMENTS: Functional status at baseline (Barthel Index (BI)) was compared with that at hospital discharge and 1-year follow-up. Health-related quality of life (HRQL Spanish version of the Medical Outcomes Study 36-item Short-From Survey) was measured at 1-year follow-up and compared with that of the Spanish population of same age. RESULTS: Of 176 individuals admitted to the ICU, 110 (62.1%) were discharged alive from the hospital, and 94 (53.1%) were alive at 1-year follow-up. ICU admission was associated with significant clinical deterioration (median BI 100 points (interquartile range (IQR) 85-100) at baseline vs 85 (IQR 60-100) at hospital discharge, P < .001). Three months after discharge, there was a significant although modest improvement in functional status (BI 95 (IQR 80-100) P = .03). Baseline functional status was not recovered at 1-year follow-up (BI 95 (IQR 80-100) P < .001). More ICU survivors had moderate to severe dependence at the end of follow-up (20.3%) than at ICU admission (6.6%) (P < .001). Factors independently associated with poor functional recovery were low baseline BI and ICU stay longer than 4 days. At 1-year follow-up, 76.8% of participants who survived were living in their own homes. HRQL was similar to that of the Spanish population of the same age. CONCLUSION: Elderly ICU survivors experienced significant deterioration in functional status, and although they recovered modestly during the following year, they never regained their baseline status. Good recovery was associated with short ICU stay and better baseline functional status. SN - 1532-5415 UR - https://www.unboundmedicine.com/medline/citation/27000326/Functional_Status_and_Quality_of_Life_in_Elderly_Intensive_Care_Unit_Survivors_ DB - PRIME DP - Unbound Medicine ER -