The Long term outcome of old patients after an ICU stay: "tell me your past history and I tell you your future"

Follow-up of old patients after an ICU stay

Abstract

The proportion of old patients admitted to intensive care has been increasing for two decades. These patients represent a specific population because of their vulnerability to stress. This vulnerability can be explained by physiological aging and frequency of comorbidities. A hospitalization in intensive care unit (ICU) represents a major stress because of the illness severity which lead to it but also, by organ replacement therapy. As consequences, mortality and loss of functional autonomy are higher than in youngers. The challenges for old patients are: 1. To identify, at ICU admission, of patients most likely to survive without loss of autonomy 2. To Propose a specialized management of these patients immediately after discharge from ICU. This management is under the joint expertise of intensivist and geriatricians. Demographic changes make the development of this collaboration essential and could give rise to a new specialty: geronto-ICU. Objectives of this review are to describe the specificities of the geriatric patients, to describe the vital and functional prognosis after ICU admission and to promote the geronto-ICU network