Journal of the American Geriatrics Society

Cognitive, Functional, and Quality-of-Life Outcomes of Patients Aged 80 and Older Who Survived at Least 1 Year After Planned or Unplanned Surgery or Medical Intensive Care Treatment

Sophia E. J. A. De Rooij MD, PhD

From the Departments of ^* Internal Medicine and Geriatrics ^† Clinical Epidemiology and Biostatistics; and ^‡ Intensive Care, Academic Medical Center, Amsterdam, the Netherlands.

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Annerike C. Govers MD,

Annerike C. Govers MD

From the Departments of ^* Internal Medicine and Geriatrics ^† Clinical Epidemiology and Biostatistics; and ^‡ Intensive Care, Academic Medical Center, Amsterdam, the Netherlands.

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Johanna C. Korevaar PhD,

Johanna C. Korevaar PhD

From the Departments of ^* Internal Medicine and Geriatrics ^† Clinical Epidemiology and Biostatistics; and ^‡ Intensive Care, Academic Medical Center, Amsterdam, the Netherlands.

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Arja W. Giesbers RN,

Arja W. Giesbers RN

From the Departments of ^* Internal Medicine and Geriatrics ^† Clinical Epidemiology and Biostatistics; and ^‡ Intensive Care, Academic Medical Center, Amsterdam, the Netherlands.

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Marcel Levi MD, PhD,

Marcel Levi MD, PhD

From the Departments of ^* Internal Medicine and Geriatrics ^† Clinical Epidemiology and Biostatistics; and ^‡ Intensive Care, Academic Medical Center, Amsterdam, the Netherlands.

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Evert De Jonge MD, PhD,

Evert De Jonge MD, PhD

From the Departments of ^* Internal Medicine and Geriatrics ^† Clinical Epidemiology and Biostatistics; and ^‡ Intensive Care, Academic Medical Center, Amsterdam, the Netherlands.

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Sophia E. J. A. De Rooij MD, PhD,

Sophia E. J. A. De Rooij MD, PhD

From the Departments of ^* Internal Medicine and Geriatrics ^† Clinical Epidemiology and Biostatistics; and ^‡ Intensive Care, Academic Medical Center, Amsterdam, the Netherlands.

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Annerike C. Govers MD,

Annerike C. Govers MD

From the Departments of ^* Internal Medicine and Geriatrics ^† Clinical Epidemiology and Biostatistics; and ^‡ Intensive Care, Academic Medical Center, Amsterdam, the Netherlands.

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Johanna C. Korevaar PhD,

Johanna C. Korevaar PhD

From the Departments of ^* Internal Medicine and Geriatrics ^† Clinical Epidemiology and Biostatistics; and ^‡ Intensive Care, Academic Medical Center, Amsterdam, the Netherlands.

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Arja W. Giesbers RN,

Arja W. Giesbers RN

From the Departments of ^* Internal Medicine and Geriatrics ^† Clinical Epidemiology and Biostatistics; and ^‡ Intensive Care, Academic Medical Center, Amsterdam, the Netherlands.

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Marcel Levi MD, PhD,

Marcel Levi MD, PhD

From the Departments of ^* Internal Medicine and Geriatrics ^† Clinical Epidemiology and Biostatistics; and ^‡ Intensive Care, Academic Medical Center, Amsterdam, the Netherlands.

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Evert De Jonge MD, PhD,

Evert De Jonge MD, PhD

From the Departments of ^* Internal Medicine and Geriatrics ^† Clinical Epidemiology and Biostatistics; and ^‡ Intensive Care, Academic Medical Center, Amsterdam, the Netherlands.

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First published: 01 April 2008

https://doi.org/10.1111/j.1532-5415.2008.01671.x

Citations: 104

Address correspondence to Sophia E.J.A. de Rooij, Department of Internal Medicine and Geriatrics, Academic Medical Center, F4-159, PO Box 22700, 1100 DE Amsterdam, the Netherlands. E-mail: [email protected]

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Abstract

OBJECTIVES: To investigate long-term cognitive, functional, and quality-of-life outcomes in very elderly survivors at least 1 year after planned or unplanned surgery or medical intensive care treatment.

DESIGN: Retrospective cohort study.

SETTING: General, 1,024-bed, tertiary university teaching hospital in the Netherlands.

PARTICIPANTS: Two hundred four survivors of a cohort of 578 patients admitted to the medical–surgical intensive care unit (ICU) between January 1997 and December 2002 and alive in December 2003. The majority of survivors underwent elective surgery.

MEASUREMENTS: From December 2003 until February 2004, data were collected from 190 patients and 169 relatives. The measures were: Informant Questionnaire on Cognitive Decline short form (IQCODE-SF) (cognition), modified Katz index of activities of daily living (ADLs) (functional status), and EuroQol (EQ-5D) (health-related quality of life). The patients themselves completed the modified Katz ADL index and EQ-5D forms; their caregivers completed the ADL caregiver version and IQCODE-SF.

RESULTS: The mean age at admission±standard deviation was 81.7±2.4, and the median time after discharge was 3.7 years (range 1–5.9 years). Of the ICU patients who had planned surgery, 57% survived, compared with 11% of the unplanned surgical admissions and 10% of the medical patients. Three-quarters (74.3%) of the patients who lived at home before ICU admission remained at home at follow-up. Eighty-three percent had no severe cognitive impairment, and 76% had no severe physical limitations (33% had moderate, 40% had mild, and 3% had no limitations). The perceived quality of life was similar to that of an age-matched general population.

CONCLUSION: Long-term survivors of ICU treatment received at the age of 80 and older showed fair-to-good cognitive and physical functioning and quality of life, although few patients who underwent unplanned surgery or who were admitted to the ICU for medical reasons survived.

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Volume56, Issue5

May 2008

Pages 816-822

Cognitive, Functional, and Quality-of-Life Outcomes of Patients Aged 80 and Older Who Survived at Least 1 Year After Planned or Unplanned Surgery or Medical Intensive Care Treatment

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Cognitive, Functional, and Quality-of-Life Outcomes of Patients Aged 80 and Older Who Survived at Least 1 Year After Planned or Unplanned Surgery or Medical Intensive Care Treatment

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