Critical illness in the elderly: Review of pathophysiology of aging and outcome of intensive care

Journal of Intensive Care Medicine

Volumn 16, Issue 3, 2001, Pages 114-127

  Chelluri, Lakshmipathi ^a  

^a UNIVERSITY OF PITTSBURGH SCHOOL OF MEDICINE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

AGING; CRITICAL ILLNESS; GERIATRIC DISORDER; HUMAN; INTENSIVE CARE; LIFESTYLE; MEDICAL DECISION MAKING; MORBIDITY; PATHOPHYSIOLOGY; PRIORITY JOURNAL; REVIEW;

EID: 0035018274     PISSN: 08850666     EISSN: None     Source Type: Journal    
DOI: 10.1046/j.1525-1489.2001.00114.x     Document Type: Review

References (130)

1. Federal Interagency Forum On Aging-Related Statistics. Older Americans 2000: key indicators of well-being [Online]. Available: www.agingstats.gov, 2000
2. Seifert ML, Heffler SK, Donham CS. Hospital, employment, and price indicators for the health care industry: first quarter 1999. Health Care Finance Rev 1999;21:79-97
3. Cerra FB, Champion H, Chulay M, et al. Critical care in the United States: coordinating intensive care resources for positive and cost efficient patient outcomes. Anaheim, CA: Society of Critical Care Medicine, 1992
4. Thibault GE, Mulley AG, Barnett GO, et al. Medical intensive care: indications, interventions, and outcomes. N Engl J Med 1980;302:938-942
5. Suresh R, Kupfer YY, Tessler S. The "greying" of the intensive care unit: demographic changes 1988-1998. Crit Care Med 1999;27:A27
6. Masaro EJ. Aging: current concepts. In: Masoro FJ, ed. Handbook of physiology. Section 11: aging. New York: Oxford University Press, 1995:3-24
7. Rowe JW, Kahn RL. Human aging: usual and successful. Science 1987;237:143-149
8. Evers BM, Townsend CM, Thompson JC. Organ physiology of aging. Surg Clin N Am 1994;74:23-39
9. Katzman R. Human nervous system. In: Masoro EJ, ed. Handbook of physiology. New York: Oxford University Press, 1995:325-344
10. Morrison JH, Hof PR. Life and death of neurons in the aging brain. Science 1997;278:412-419
11. Francis J, Martin D, Kapoor WN. A prospective study of delirium in hospitalized elderly. JAMA 1990;263:1097-1101
12. Litt B, Wityk RJ, Hertz SH, et al. Nonconvulsive status epilepticus in the critically ill elderly. Epilepsia 1998;39: 1194-1202
13. Lakatta EG. Cardiovascular system. In: Masoro EJ, ed. Handbook of physiology. New York: Oxford University Press, 1995:413-474
14. Wei JY. Age and the cardiovascular system. N Engl J Med 1992;327:1735-1739
15. Watters JM, Bessey PQ. Critical care for the elderly patient. Surg Clin N Am 1994;74:187-197
16. Fleg JL, Kennedy HL. Cardiac arrhythmias in a healthy elderly population. Chest 1982;81:302-307
17. Yin FCP, Raizes GS, Guarnieri T, et al. Age-associated decrease in ventricular response to haemodynamic stress during beta-adrenergic blockade. Br Heart J 1978;40: 1349-1355
18. Sparrow D, Weiss ST. Respiratory system. In: Masaro EJ, ed. Handbook of physiology. New York: Oxford University Press, 1995:475-484
19. Lindeman RD. Renal and urinary tract function. In: Masaro EJ, ed. Handbook of physiology. New York: Oxford University Press, 1995:485-504
20. Snyder NA, Feigal DW, Arieff AI. Hypernatremia in elderly patients. Ann Intern Med 1987;107:309-319
21. Anderson RJ, Chung H, Kluge R, et al. Hyponatremia: a prospective analysis of its epidemiology and the pathogenetic role of vasopressin. Ann Intern Med 1985;102:164-168
22. Zaloga GP, Hughes SS. Oliguria in patients with normal renal function. Anesthesiology 1990;72:598-602
23. Sunderam SG, Mankikar GD. Hyponatraemia in the elderly. Age Ageing 1983;12:77-80
24. Duetsch S, Goldberg M, Dripps RD. Postoperative hyponatremia with the inappropriate release of antidiuretic hormone. Anesthesiology 1966;27:250-256
25. Cheng ATH, Plank LD, Hill GL. Prolonged overexpansion of extracellular water in elderly patients with sepsis. Arch Surg 1998;133:745-751
26. Gentric A, Cledes J. Immediate and long-term prognosis in acute renal failure in the elderly. Nephrol Dial Transplant 1991;6:86-90
27. Pascual J, Liano F. Causes and prognosis of acute renal failure in the very old. J Am Geriatr Soc 1998;46:721-725
28. Holt PR. The gastrointestinal tract. In: Masoro EJ, ed. Handbook of physiology. New York: Oxford University Press, 1995:505-554
29. Sullivan DH, Moriarty MS, Chernoff R, et al. Patterns of care: an analysis of the quality of nutritional care routinely provided to elderly hospitalized veterans. J Patenteral Enteral Nutr 1989;13:249-254
30. Sullivan DH, Sun S, Wall RG. Protein-energy undernutrition among elderly hospitalized patients. A prospective study. JAMA 1999;281:2013-2019
31. Cederholm T, Hellstrom K. Nutritional status in recently hospitalized and free-living elderly subjects. Gerontology 1992;38:105-110
32. Constans T, Bacq Y, Brechot JF, et al. Protein-energy malnutrition in elderly medical patients. J Am Geriatr Soc 1992; 40:263-268
33. Olin AO, Osterberg P, Hadell K, et al. Energy-enriched hospital food to improve energy intake in elderly patients. J Parenteral Enteral Nutr 1996;20:93-97
34. Collins KJ, Exton-Smith AN. Thermal homeostasis in old age. J Am Geriatr Soc 1983;31:519-524
35. Lybarger JA, Kilbourne EM. Hypothermia and hypothermia in the elderly: an epidemiologic review. In: Davis BB, Wood WG, eds. Homeostatic function and aging. New York: Raven Press, 1985:149-156
36. Kramer MR, Vandijk J, Rosin AJ. Mortality in elderly patients with thermoregulatory failure. Arch Intern Med 1989;149: 1521-1523
37. Miller RA. The aging immune system: primer and prospectus. Science 1996;273:70-74
38. Caruso C, DiLorenzo G, Cigna D, et al. Cytokine production pathway in elderly subjects. J Immunol Immunopharmacol 1992;12:210-212
39. Caruso C, Candore G, Cigna D, et al. Cytokine production pathway in the elderly. Immunol Res 1996;15:84-90
40. Ferguson FG, Wikby A, Maxson P, et al. Immune parameters in a longitudinal study of a very old population of Swedish people: a comparison between survivors and nonsurvivors. J Gerontol 1995;50A:B378-B382
41. Bender BS, Nagel JE, Adler WH, et al. Absolute peripheral blood lymphocyte count and subsequent mortality of elderly men. J Am Geriatr Soc 1986;34:649-654
42. Wayne SJ, Rhyne RL, Carry PJ, et al. Cell-mediated immunity as a predictor of morbidity and mortality in subjects over 60. J Gerontol 1990;45:M45-M48
43. Nielson C. Pharmacologic considerations in critical care of the elderly. Clin Geriatr Med 1994;10:71-89
44. Riedinger JL, Robbins LJ. Prevention of iatrogenic illness: adverse drug reactions and nosocomial infections in hospitalized older adults. Clin Geriatr Med 1998;14:681-698
45. Niemiec PW, Smith CR, Lietman PS. Effect of altered volume of distribution on aminoglycoside levels in patients in surgical intensive care. Arch Surg 1987;122:207-212
46. Marcantonio ER, Goldman L, Mangione CM, et al. A clinical prediction rule for delirium after elective noncardiac surgery. JAMA 1994;271:134-139
47. Duppils GS, Wikblad K. Acute confusional states in patients undergoing hip surgery. Gerontology 2000;46:36-43
48. Chelluri L, Grenvik A, Silverman M. Intensive care for critically ill elderly: mortality, costs, quality of life. Arch Intern Med 1995;155:1013-1022
49. Nuckton TJ, List ND. Age as a factor in critical care unit admissions. Arch Intern Med 1995;155:1087-1092
50. Hanson LC, Danis M. Use of life-sustaining care for the elderly. J Am Geriatr Soc 1991;39:772-777
51. Narain P, Rubenstein LZ, Wieland GD, et al. Predictors of immediate and 6-month outcomes in hospitalized elderly patients: the importance of functional status. J Am Geriatr Soc 1988;36:775-783
52. Mick DJ, Ackerman MA. Neutralizing ageism in critical care via outcomes research. AACN Clin Issues 1997;8:597-608
53. Alemayehu E, Molloy DW, Guyatt GH, et al. Variability in physicians' decisions on caring for chronically ill elderly patients: an international study. Can Med Assoc J 1991;144: 1133-1138
54. Fakhry SM, Kercher KW, Rutledge R. Survival, quality of life, and charges in critically ill surgical patients requiring prolonged ICU stays. J Trauma 1996;41:999-1007
55. Hamel MB, Davis RB, Teno JM, et al. Older age, aggressiveness of care, and survival for seriously ill, hospitalized adults. Ann Intern Med 1999;131:721-728
56. Kettunen J, Paajanen H, Kostiainen S. Emergency abdominal surgery in the elderly. Hepatogastronenterology 1995; 42:106-108
57. Kolh P, Lahaye L, Gerard P, et al. Aortic valve replacement in the octogenarians: perioperative outcome and clinical follow-up. Eur J Cardiothor Surg 1999;16:68-73
58. Fong Y, Brennan MF, Cohen AM, et al. Liver resection in the elderly. Br J Surg 1997;84:1386-1390
59. Bromley PN, Hilmi I, Tan KC, et al. Orthotopic liver transplantation in patients over 60 years old. Transplantation 1994;58:800-803
60. Stroumbakis N, Herr HW, Cookson MS, et al. Radical cystectomy in the octogenarian. J Urol 1997;158:2113-2117
61. Keller SM, Markovitz LJ, Wilder JR, et al. Emergency and elective surgery in patients over age 70. Am Surg 1987;53: 636-640
62. Beernaerts A. Surgery in the aged. Associated pathologies of aged people. Acta Chir Belg 1993;93:112-114
63. Shapiro MB, Dechert RE, Colwell C, et al. Geriatric trauma: aggressive intensive care unit management is justified. Am Surg 1994;60:695-698
64. Knudson MM, Lieberman J, Morris JA, et al. Mortality factors in geriatric blunt trauma patients. Arch Surg 1994;129: 448-453
65. Shabot MM, Johnson CL. Outcome from critical care in the "oldest old" trauma patients. J Trauma 1995;39:254-260
66. van der Sluis CK, Klasen HJ, Eisma WH, et al. Major trauma in young and old: what is the difference? J Trauma 1996; 40:78-82
67. Margulies DR, Lekawa ME, Bjerke HS, et al. Surgical intensive care in the nonagenarian: no basis for age discrimination. Arch Surg 1993;128:753-758
68. Davis RB, lezzoni LI, Phillips RS, et al. Predicting in-hospital mortality: the importance of functional status information. Med Care 1995;33:906-921
69. Inouye SK, Peduzzi PN, Robison JT, et al. Importance of functional measures in predicting mortality among older hospitalized patients. JAMA 1998;279:1187-1193
70. Konopad E, Noseworthy TW, Johnston R, et al. Quality of life measures before and one year after admission to an intensive care unit. Crit Care Med 1995;23:1653-1659
71. Kleinpell RM, Ferrans CE. Factors influencing intensive care unit survival for critically ill elderly patients. Heart Lung 1998;27:337-343
72. Ip SPS, Leung YF, Ip CY, et al. Outcomes of critically ill elderly patients: is high-dependency care for geriatric patients worthwhile? Crit Care Med 1999;27:2351-2357
73. Morrison RS, Siu AL. Survival in end-stage dementia following acute illness. JAMA 2000;284:47-52
74. Stauffer JL, Fayter NA, Graves B, et al. Survival following mechanical ventilation for acute respiratory failure in adult men. Chest 1993;104:1222-1229
75. Ely EW, Evans GW, Haponik EF. Mechanical ventilation in a cohort of elderly patients admitted to an intensive care unit. Ann Intern Med 1999;131:96-104
76. Cohen IL, Lambrinos J, Fein IA. Mechanical ventilation for the elderly patient in intensive care. JAMA 1993;269: 1025-1029
77. Cohen IL, Lambrinos J. Investigating the impact of age on outcome of mechanical ventilation using a population of 41,848 patients from a statewide database. Chest 1995;107: 1673-1680
78. Swinburne AJ, Fedullo AJ, Bixby K, et al. Respiratory failure in the elderly: analysis of outcome after treatment with mechanical ventilation. Arch Intern Med 1993;153: 1657-1662
79. Kollef MH. Do age and gender influence outcome from mechanical ventilation? Heart Lung 1993;22:442-449
80. Meinders AJ, Van Der Hoeven JG, Meinders AE. The outcome of prolonged mechanical ventilation in elderly patients: are the efforts worthwhile? Age Ageing 1996;25: 353-356
81. Zilberberg MD, Epstein SK. Acute lung injury in the medical ICU. Comorbid conditions, age, etiology, and hospital outcome. Am J Resp Crit Care Med 1998;157:1159-1164
82. Eddelston JM, White P, Guthrie E. Survival, morbidity, and quality of life after discharge from intensive care. Crit Care Med 2000;28:2293-2299
83. Montuclard L, Garrouste-Orgeas M, Timsit J, et al. Outcome, functional autonomy, and quality of life of elderly patients with a long-term intensive care unit stay. Crit Care Med 2000;28:3389-3395
84. Behrendt CE. Acute respiratory failure in the United States. Incidence and 31-day survival. Chest 2000;118:1100-1105
85. Chelluri L, Pinsky MR, Genvik A, et al. Long-term out come of critically ill elderly patients. JAMA 1993;269:3119-3123
86. Testa MA, Simonson DC. Assessment of quality-of-life outcomes. N Engl J Med 1996;334:835-840
87. Applegate WB, Blass JP, Williams TF. Instruments for the functional assessment of older patients. N Engl J Med 1990; 322:1207-1214
88. Katz S, Ford AB, Moskowitz RW, et al. Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function. JAMA 1963;185: 914-919
89. Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969;9:179-186
90. Ware J. SF-36 health survey. Boston: New England Medical Center, 1993
91. Folstein MF, Folstein SE, McHugh PR. "Mini-mental state": a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189-198
92. Vitaliano PP, Breen AR, Russo J, et al. The clinical utility of the dementia rating scale for assessing Alzheimer's patients. J Chron Dis 1984;37:743-753
93. Radloff LS. CES-D scale. Appl Psychol Meas 1977;1:385-401
94. Yeseavage JA, Brink TL, Rose TL. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 1982;17:37-49
95. Essink-Bot ML, Krabbe PFM, Bonsel GJ, et al. An empirical comparison of four generic health status measures. Med Care 1997;35:522-537
96. Andersen EM, Rothenberg BM, Kaplan RM. Performance of a self-administered mailed, version of the quality of well-being (QEB-SA) questionnaire among older adults. Med Care 1998;36:1349-1360
97. Guyatt G, Feeny D, Patrick D. Issues in quality of life measurement in clinical trials. Control Clin Trials 1991; 12(suppl):81-90
98. Weinberger M, Samsa GP, Schmader K, et al. Comparing proxy and patients' perceptions of patients' functional status: results from an outpatient geriatric clinic. J Am Geriatr Soc 1992;40:585-588
99. Rogers J, Ridley S, Chrispin P, et al. Reliability of the next of kin's' estimates of critically ill patients' quality of life. Anesthesia 1997;52:1137-1143
100. Farquhar M. Elderly people's definitions of quality of life. Soc Sci Med 1995;41:1439-1446
101. Weinert CR, Gross CR, Kangas JR, et al. Health-related quality of life after acute lung injury. Am J Respir Crit Care Med 1997;156:1120-1128
102. Davidson TA, Caldwell ES, Curtis JR, et al. Reduced quality of life in survivors of acute respiratory distress syndrome compared with critically ill control patients. JAMA 1999; 281:354-360
103. Hopkins RO, Weaver LK, Pope D, et al. Neuropsychological sequelae and impaired health status in survivors of severe acute respiratory distress syndrome. Am J Respir Crit Care Med 1999;160:50-56
104. Schelling G, Stoll C, Haller M, et al. Health-related quality of life and posttraumatic stress disorder in survivors of the acute respiratory distress syndrome. Crit Care Med 1998; 26:651-659
105. Oye RK, Bellamy PE. Patterns of resource consumption in medical intensive care unit. Chest 1991;99:685-689
106. Fein IA, Cole E, Socaris S, et al. Assessing resource utilization in a surgical critical care unit. Chest 1991;100(suppl): 80
107. Kurek CJ, Cohen IL, Lambrinos J, et al. Clinical and economic outcome of patients undergoing tracheostomy for prolonged mechanical ventilation in New York state during 1993; analysis of 6,353 cases under diagnosis-related group 483. Crit Care Med 1997;25:983-988
108. Kurek CJ, Dewar D, Lambrinos J, et al. Clinical and economic outcome of mechanically ventilated patients in New York state during 1993. Chest 1998;114:214-222
109. Castillo-Lorente E, Rivera-Fernandez R, Vazquez-Mata G. Limitation of therapeutic activity in elderly critically ill patients. Crit Care Med 1997;25:1643-1648
110. Hamel MB, Phillips RS, Teno JM, et al. Seriously ill hospitalized adults: do we spend less on older patients? J Am Geriatr Soc 1996;44:1043-1048
111. Hamel MB, Teno JM, Goldman L, et al. Patient age and decisions to withhold life-sustaining treatments from seriously ill, hospitalized patients. Ann Intern Med 1999;130: 116-125
112. Chelluri L, Mendelsohn AB, Sirio CA, et al. Age and hospital costs in patients receiving prolonged mechanical ventilation. Am J Respir Crit Care Med 2000;161:A556
113. Schapira DV, Studnicki J, Bradham DD, et al. Intensive care, survival, and expense of treating critically ill cancer patients. JAMA 1993;269:783-786
114. Esserman L, Belkora J, Lenert L. Potentially ineffective care. JAMA 1995;274:1544-1551
115. Cher DJ, Lenert LA. Method of Medicare reimbursement and rate of potentially ineffective care of critically ill patients. JAMA 1997;278:1001-1007
116. Uhlmann RF, Pearlman RA. Perceived quality of life and preferences for life-sustaining treatment in older adults. Arch Intern Med 1991;151:495-497
117. Patrick DL, Pearlman RA, Starks HE, et al. Validation of preferences for life-sustaining treatment: implications for advance care planning. Ann Intern Med 1997;127:509-517
118. Tsevat J, Cook EF, Green ML, et al. Health values of the seriously ill. Ann Intern Med 1995;122:514-520
119. Mazur DJ. How older patient preferences are influenced by consideration of future health outcomes. J Am Geriatr Soc 1997;45:725-728
120. Danis M, Garrett J, Harris R, et al. Stability of choices about life-sustaining treatments. Ann Intern Med 1994;120: 567-573
121. Teno JM, Licks S, Lynn J, et al. Do advance directives provide instructions that direct care? J Am Geriatr Soc 1997; 45:508-512
122. Goodman MD, Tarnoff M, Slotman GJ. Effect of advance directives on the management of elderly critically ill patients. Crit Care Med 1998;26:701-704
123. Siegler EL, Levin BW. Physician-older patient communication at the end of life. Clin Geriatr Med 2000;16:175-204
124. Gamble ER, McDonald PJ, Lichstein PR. Knowledge, attitudes, and behavior of elderly persons regarding living wills. Arch Intern Med 1991;151:277-280
125. Lo B, McLeod GA, Saika G. Patient attitudes to discussing life sustaining treatment. Arch Intern Med 1986;146: 1613-1615
126. Azoulay E, Chevret S, Leleu G, et al. Half the families of intensive care unit patients experience inadequate communication with physicians. Crit Care Med 2000;28:3044-3049
127. Devita MA, Sirio CA, Paronish R, et al. ICU patients are unlikely to receive council regarding levels of support. Chest 1999;116(suppl):S239
128. Seckler AB, Meier DE, Mulvihill M, et al. Substituted judgment: how accurate are proxy predications? Ann Intern Med 1991;115:92-98
129. Danis M, Gerrity MS, Southerland LI, et al. A comparison of patient, family, and physician assessments of the value of medical intensive care. Crit Care Med 1988;16:594-600
130. Uhlmann RF, Pearlman RA, Cain KC. Understanding of elderly patients' resuscitation preferences by physicians and nurses. West J Med 1989;150:705-707