Octogenarians in the ICU are you ever too old 英文参考文献.docVIP

McDermid and Bagshaw Critical Care 2011,15:125 /content/15/1/125 COMMENTARY Octogenarians in the ICU: are you ever too old? Robert C McDermid and Sean M Bagshaw* See related research by Roch et al., /content/15/1/R36 (18.0%) a median 5.3 years after hospital discharge, where Abstract overall scores for physical function were greatly reduced. Long-term morbidity and mortality rates for older patients admitted to the ICU remain substantial. In this issue of Critical Care, Roch and colleagues describe a retrospective study evaluating factors associated with survival and quality-of-life of octogenarians (aged ≥80 years) admitted to a medical ICU. This study proposes to address a highly relevant and increasingly encountered scenario in ICUs - what factors can best estimate prognosis for elderly patients at the time of evaluation for ICU admission? While perhaps not unique to octogenarians, such data have the potential to better inform on decision-making regarding advanced life support along with facilitating discussion on the perceived bene?t and on patient treatment preferences concerning intensive care. While these ? ndings are provocative and extend our knowledge of the outcomes for elderly patients su? ering an episode of critical illness, this study also has important limitations that challenge its inferences and overall generalizability. First, it re? ects a relatively small cohort of elderly patients admitted to a single tertiary medical ICU in France. Second, this study does not directly provide insight on the prognostic impact of age alone on long-term outcome after critical illness, due to lack of controls for comparis ird, while 12.4% of all admis- sions to this ICU were aged ≥80 years, we do not know the prevalence of age-matched patients referred to, but not admitted to ICU, thus making these observations potentially susceptible to selection bias. In total, 23% of patients were classi