Treatment Intensity/Factors Predicting Short and Long Term Outcomes in Elderly Critically Ill Patients

Treatment Intensity and Factors Predicting Short and Long Term Outcomes in Elderly and Very Elderly Patients Admitted to Intensive Care Units

1. Patients greater than 90 years of age will have poorer outcomes in terms of mortality than younger patients controlling for disease and acuity
2. Patients greater than 90 years old will consume more resources than younger patients controlling for disease and acuity
3. Patients greater than 90 years old will show lower levels of function than younger patients controlling for disease and acuity
4. Patients greater than 90 years old will show lower levels of HRQOL at 90-120 days post ICU discharge than younger patients controlling for disease and acuity

Study Overview

• Status: Completed
• Conditions: Critically Ill Very Elderly Patients Admitted to ICU's

Detailed Description

Elderly patients make up between 26% and 51% of patients who are admitted to ICUs. The proportion of individuals in North America aged > 65 is projected to increase to 20% of the population by 2026. As population demographics change, and as new technologies, pharmaceuticals, and interventions prolong lives, the proportion of elderly patients admitted to ICUs and surviving ICU stay will continue to increase. Studies that have examined only ICU or hospital survival as an outcome have had variable results. Few studies have demonstrated that elderly ICU patients experience higher mortality rates, while others have demonstrated that age alone, when adjusted for other factors, is not an important prognostic indicator among elderly patients admitted to the intensive care units (ICU). However, age is still used as an important criteria for admission to ICUs. Most studies reviewed have looked at patients sixty-five to ninety years old. To our knowledge only two studies to date have addressed this issue among patients older than 90 to an ICU, both were retrospective.

With increasing age there is a parallel increase in health care costs. The use of expensive technology and procedures in the very elderly is fast becoming a major concern. Data on resource allocation and treatment intensity in the (90+) subgroup is sparse.

Beyond mortality and cost, health-related quality of life (HRQOL) is a fundamentally important end point of medical care. Few studies have addressed outcomes in terms of HRQOL and functional status of elderly following discharge the from critical care unit. These studies were limited by small number of subjects enrolled, retrospective design, and lack of validated tool to assess HRQOL.

We plan to prospectively collect data to look at determinants of treatment intensity, outcome, and resource allocation in elderly patients ages 65 and above admitted to the ICU with care taken to including as many patients in the age interval above 90 years of age. We will also assess HRQOL and functional status in very elderly patients who survive admission and are discharged from the hospital.

• Study Type: Observational
• Enrollment (Actual): 399

Contacts and Locations

Study Locations

• United States
  • New York
    • New York, New York, United States, 10019
      • St. Luke's Roosevelt Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 65 years and older (Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

Critically Ill Elderly Patients

Description

Inclusion Criteria:

• Patients 65 year an older Admitted to MICU, SICU, and CCU

Exclusion Criteria:

• Patients who refuse to complete HRQL questionaire while hospitalized
• Subjects refuse to participate

Study Plan

How is the study designed?

Collaborators and Investigators

• Sponsor: St. Luke's-Roosevelt Hospital Center

Study record dates

Study Major Dates

• Study Start: July 1, 2007
• Study Completion (Actual): August 1, 2012

Study Registration Dates

• First Submitted: November 5, 2007
• First Submitted That Met QC Criteria: November 5, 2007
• First Posted (Estimate): November 7, 2007

Study Record Updates

• Last Update Posted (Estimate): August 23, 2012
• Last Update Submitted That Met QC Criteria: August 22, 2012
• Last Verified: August 1, 2012

More Information

Terms related to this study

• Keywords: Elderly; Quality of Life; ICU; Outcome
• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Critical Illness
• Other Study ID Numbers: 06-171