Predicting whether the ICU can help older patients score needed 英文参考文献.docVIP

Available online /content/9/4/331 Commentary Predicting whether the ICU can help older patients: score needed Maité Garrouste-Orgeas and Jean Carlet Medical-Surgical ICU, Saint Joseph Hospital, 75014 Paris, France Corresponding author: Maité Garrouste-Orgeas, mgarrouste@ Published online: 22 June 2005 Critical Care 2005, 9:331-332 (DOI 10.1186/cc3750) This article is online at /content/9/4/331 ? 2005 BioMed Central Ltd See related research by De Rooij et al. in this issue [/content/9/4/R307] Abstract In this editorial, we will discuss two important aspects. Firstly, as emphasized by De Rootj et al., studies that have assessed outcomes of elderly patients have included admitted patients instead of patients triaged for ICU admission. Patients with severe impairments and the very oldest may be under- represented among admitted patients, which would bias the results toward better outcomes. Although age per se is an Because the need for intensive care exceeds its availability in several countries, intensivists must admit those patients most likely to benefit. Intensive care unit admissions of elderly patients will increase substantially in the near future. Decreased self sufficiency and quality of life are common after hospitalization in older patients and they may require discharge to a nursing home, although some patients feel that life in a nursing home would be worse than dying. We have much to learn about matching the use of life-supporting treatments to the health-related values of older patients. A specific outcome-prediction score for older patients would help improve quality of care. important determinant of hospital mortality, the most important determinant of ICU mortality is severity of the acute illness, as shown by studies taking this important factor into account (see, for example [2]). Age and severe disability have major effects on long-term outcomes [4]. I