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Original Research |

Changes of Health-Related Quality of Life in Critically Ill OctogenariansQuality of Life in Critically Ill Octogenerians: A Follow-up Study

José G. M. Hofhuis, PhD; Henk F. van Stel, PhD; Augustinus J. P. Schrijvers, PhD; Johannes H. Rommes, MD, PhD; Peter E. Spronk, MD, PhD, FCCP
Author and Funding Information

From the Department of Intensive Care (Drs Hofhuis, Rommes, and Spronk), Gelre Hospital, Apeldoorn; Julius Center for Health Sciences and Primary Care (Drs van Stel and Schrijvers), University Medical Center, Utrecht; and Department of Intensive Care (Dr Spronk), Academic Medical Center, Amsterdam, The Netherlands.

Correspondence to: José G. M. Hofhuis, PhD, Department of Intensive Care, Gelre Ziekenhuizen, Apeldoorn, Albert Schweitzerlaan 31, 7334 DZ Apeldoorn, The Netherlands; e-mail: j.hofhuis@gelre.nl

Data are presented as median (interquartile range) or No. (%). APACHE = Acute Physiology and Chronic Health Evaluation; LOS = length of stay.

a

Emergency surgical is defined as unplanned surgery.

b

Elective surgical is defined as ICU admission planned within 24 h before surgery.

BPN = bodily pain; GH = general health; MCS = mental component score; MH = mental health; PCS = physical component score; PF = physical functioning; RE = role limitation due to emotional problems; RP = role limitation due to physical problems; SF = social functioning; SF-36 = Medical Outcomes Study 36-item short form; VT = vitality.

a

Linear mixed model with random intercept and random slope (for time). Detailed results are shown in e-Table 1.

b

Pre-ICU estimate: change in discharge ICU score (intercept) for 1-point-higher pre-ICU score.

c

Difference in discharge ICU score (intercept) for patients aged > 80 vs < 80 years.

Data are presented as mean ± SD, unless otherwise indicated. Effect size ≥ 0.20 is small; ≥ 0.50, medium; and > 0.80, large. The mean age was > 80 y in the age-matched general population group. df = degrees of freedom. See Table 2 legend for expansion of other abbreviations.

a

Wilcoxon test.

b

One-sample t test (all tests df, 48).

c

P significant after Bonferroni correction.

Data are presented as mean ± SD. Effect size ≥ 0.20 is small; ≥ 0.50, medium; and > 0.80, large. See Table 2 legend for expansion of abbreviations.

a

Wilcoxon test.

b

P significant after Bonferroni correction.

Funding/Support: The authors have reported to CHEST that no funding was received for this study.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


Funding/Support: The authors have reported to CHEST that no funding was received for this study.

Funding/Support: The authors have reported to CHEST that no funding was received for this study.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


Chest. 2011;140(6):1473-1483. doi:10.1378/chest.10-0803
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Background:  Intensivists frequently are concerned about whether octogenarians actually will benefit from ICU admission. We studied changes in health-related quality of life (HRQOL) 6 months following ICU discharge in those patients.

Methods:  We performed a long-term prospective study in a medical-surgical ICU. Patients aged ≥ 80 years (n = 129) and < 80 years (n = 620) admitted for > 48 h were included. We used the Medical Outcomes Study 36-item short form (SF-36) to evaluate HRQOL before ICU admission (using proxies), at ICU discharge, at hospital discharge, and at 3 and 6 months following ICU discharge, using a linear mixed model.

Results:  At 6 months after ICU discharge, 49 patients aged ≥ 80 years and 352 patients aged < 80 years could be evaluated. At ICU discharge, physical functioning was far lower than mental functioning (physical component score, 24.9; mental component score, 46.1) in the octogenerians. Most SF-36 dimensions showed significant improvement over time (all P < .01, except role-emotional [P = .038] and bodily pain [P = .77]). In the octogenarians, mean SF-36 scores 6 months after ICU discharge were comparable to baseline in all dimensions. Most dimensions of the SF-36 were not significantly lower in surviving octogenarians at 6 months after ICU discharge compared with the normal population.

Conclusions:  We demonstrated a good recovery of HRQOL in octogenarians surviving critical illness. The findings suggest that denying admission to the ICU should not just rely on old age.

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