Caring for the critically ill patients over 80: a narrative review

Bertrand Guidet; Helene Vallet; Jacques Boddaert; Dylan W de Lange; Alessandro Morandi; Guillaume Leblanc; Antonio Artigas; Hans Flaatten

doi:10.1186/s13613-018-0458-7

Caring for the critically ill patients over 80: a narrative review

Bertrand Guidet, Helene Vallet, Jacques Boddaert, Dylan W de Lange, Alessandro Morandi, Guillaume Leblanc, Antonio Artigas, Hans Flaatten

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Abstract

BACKGROUND: There is currently no international recommendation for the admission or treatment of the critically ill older patients over 80 years of age in the intensive care unit (ICU), and there is no valid prognostic severity score that includes specific geriatric assessments.

MAIN BODY: In this review, we report recent literature focusing on older critically ill patients in order to help physicians in the multiple-step decision-making process. It is unclear under what conditions older patients may benefit from ICU admission. Consequently, there is a wide variation in triage practices, treatment intensity levels, end-of-life practices, discharge practices and frequency of geriatrician's involvement among institutions and clinicians. In this review, we discuss important steps in caring for critically ill older patients, from the triage to long-term outcome, with a focus on specific conditions in the very old patients.

CONCLUSION: According to previous considerations, we provide an algorithm presented as a guide to aid in the decision-making process for the caring of the critically ill older patients.

Original language	English
Article number	114
Journal	Annals of Intensive Care
Volume	8
Issue number	1
DOIs	https://doi.org/10.1186/s13613-018-0458-7
Publication status	Published - 26 Nov 2018

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title = "Caring for the critically ill patients over 80: a narrative review",

abstract = "BACKGROUND: There is currently no international recommendation for the admission or treatment of the critically ill older patients over 80 years of age in the intensive care unit (ICU), and there is no valid prognostic severity score that includes specific geriatric assessments.MAIN BODY: In this review, we report recent literature focusing on older critically ill patients in order to help physicians in the multiple-step decision-making process. It is unclear under what conditions older patients may benefit from ICU admission. Consequently, there is a wide variation in triage practices, treatment intensity levels, end-of-life practices, discharge practices and frequency of geriatrician's involvement among institutions and clinicians. In this review, we discuss important steps in caring for critically ill older patients, from the triage to long-term outcome, with a focus on specific conditions in the very old patients.CONCLUSION: According to previous considerations, we provide an algorithm presented as a guide to aid in the decision-making process for the caring of the critically ill older patients.",

author = "Bertrand Guidet and Helene Vallet and Jacques Boddaert and {de Lange}, {Dylan W} and Alessandro Morandi and Guillaume Leblanc and Antonio Artigas and Hans Flaatten",

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T2 - a narrative review

AU - Guidet, Bertrand

AU - Vallet, Helene

AU - Boddaert, Jacques

AU - de Lange, Dylan W

AU - Morandi, Alessandro

AU - Leblanc, Guillaume

AU - Artigas, Antonio

AU - Flaatten, Hans

PY - 2018/11/26

Y1 - 2018/11/26

N2 - BACKGROUND: There is currently no international recommendation for the admission or treatment of the critically ill older patients over 80 years of age in the intensive care unit (ICU), and there is no valid prognostic severity score that includes specific geriatric assessments.MAIN BODY: In this review, we report recent literature focusing on older critically ill patients in order to help physicians in the multiple-step decision-making process. It is unclear under what conditions older patients may benefit from ICU admission. Consequently, there is a wide variation in triage practices, treatment intensity levels, end-of-life practices, discharge practices and frequency of geriatrician's involvement among institutions and clinicians. In this review, we discuss important steps in caring for critically ill older patients, from the triage to long-term outcome, with a focus on specific conditions in the very old patients.CONCLUSION: According to previous considerations, we provide an algorithm presented as a guide to aid in the decision-making process for the caring of the critically ill older patients.

AB - BACKGROUND: There is currently no international recommendation for the admission or treatment of the critically ill older patients over 80 years of age in the intensive care unit (ICU), and there is no valid prognostic severity score that includes specific geriatric assessments.MAIN BODY: In this review, we report recent literature focusing on older critically ill patients in order to help physicians in the multiple-step decision-making process. It is unclear under what conditions older patients may benefit from ICU admission. Consequently, there is a wide variation in triage practices, treatment intensity levels, end-of-life practices, discharge practices and frequency of geriatrician's involvement among institutions and clinicians. In this review, we discuss important steps in caring for critically ill older patients, from the triage to long-term outcome, with a focus on specific conditions in the very old patients.CONCLUSION: According to previous considerations, we provide an algorithm presented as a guide to aid in the decision-making process for the caring of the critically ill older patients.

U2 - 10.1186/s13613-018-0458-7

DO - 10.1186/s13613-018-0458-7

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SN - 2110-5820

VL - 8

JO - Annals of Intensive Care

JF - Annals of Intensive Care

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M1 - 114

ER -

Caring for the critically ill patients over 80: a narrative review

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