Data from The American College of Critical Care Medicine - Curated by EPG Health - Date available 01 June 2015

Availability

Free full text

Original date published

1 June 2015

Original format

Print publication

OBJECTIVE: To review how disability can develop in older adults with critical illness and to explore ways to reduce long-term disability following critical illness.

DATA SOURCES: We searched PubMed, CINAHL, Web of Science and Google Scholar for studies reporting disability outcomes (i.e., activities of daily living, instrumental activities of daily living, and mobility activities) and/or cognitive outcomes among patients treated in an ICU who were 65 years or older. We also reviewed the bibliographies of relevant citations to identify additional citations.

STUDY SELECTION: We identified 19 studies evaluating disability outcomes in critically ill patients who were 65 years and older.

DATA EXTRACTION: Descriptive epidemiologic data on disability after critical illness.

DATA SYNTHESIS: Newly acquired disability in activities of daily living, instrumental activities of daily living, and mobility activities was commonplace among older adults who survived a critical illness. Incident dementia and less severe cognitive impairment were also highly prevalent. Factors related to the acute critical illness, ICU practices, such as heavy sedation, physical restraints, and immobility, as well as aging physiology, and coexisting geriatric conditions can combine to result in these poor outcomes.

CONCLUSIONS: Older adults who survive critical illness have physical and cognitive declines resulting in disability at greater rates than hospitalized, noncritically ill and community dwelling older adults. Interventions derived from widely available geriatric care models in use outside of the ICU, which address modifiable risk factors including immobility and delirium, are associated with improved functional and cognitive outcomes and can be used to complement ICU-focused models such as the ABCDEs.

Data sources

Read abstract on library site Access full article

Comments

You will need to login, to leave a comment.

epgonline.org is not monitored for collection of adverse event reports. Any adverse events should be reported to your national reporting agency and/or the manufacturer.

Learning Zones

An epgonline.org Learning Zone (LZ) is an area of the site dedicated to providing detailed self-directed medical education about a disease, condition or procedure.

Fluid Management

Fluid Management

Are you up-to-date with the latest evidence of effective procedures for fluid management?

+ 2 more

Fibrinogen Deficiency in Bleeding

Fibrinogen Deficiency in Bleeding

Fibrinogen is important for blood clot formation and breakdown. It is the first coagulant factor to be reduced to critical levels during massive trauma, cardiac surgery and postpartum haemorrhage that involve excessive bleeding. Persistent fibrinogen deficiency can lead to bleeding complications and an increased risk in mortality. This learning zone looks at both congenital and acquired fibrinogen deficiencies including indications and techniques for diagnosis, trigger level for treatment and treatment options.

Chronic Lymphocytic Leukaemia (CLL)

Chronic Lymphocytic Leukaemia (CLL)

Refine your knowledge of chronic lymphocytic leukaemia (CLL) with information on pathophysiology, diagnosis, treatment options and more

+ 1 more

Load more

Related Content