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. 2022 Jul;37(7):970-978.
doi: 10.1177/08850666211052460. Epub 2021 Nov 10.

Self-perceived recovery and quality of life in elderly patients surviving ICU-admission for abdominal sepsis

Anne C M Cuijpers  1   2   3 , Marielle M E Coolsen  1 , Ronny M Schnabel  2 , Tim Lubbers  1   3 , Iwan C C van der Horst  2   4 , Susanne van Santen  2 , Steven W M Olde Damink  1   5   6 , Marcel C G van de Poll  1   2   5
Affiliations

Self-perceived recovery and quality of life in elderly patients surviving ICU-admission for abdominal sepsis

Anne C M Cuijpers et al. J Intensive Care Med. 2022 Jul.

Abstract

Introduction: Concern for loss of physical performance and Health-Related Quality of Life (HRQoL) may raise doubts regarding the meaningfulness of an Intensive Care (ICU) admission in elderly patients. We evaluated self-perceived long-term recovery and satisfaction in elderly surviving an abdominal sepsis related ICU-admission and related this to objective measures of HRQoL.

Methods: A cross-sectional survey study was performed in all ICU-survivors with age ≥70 admitted with abdominal sepsis. HRQoL, frailty and self-perceived long-term recovery were measured using the EQ-5D-3L, Groningen Frailty Indicator, and a self-developed questionnaire, respectively.

Results: Of 144 patients admitted, 48 were alive at follow up (2.42 [0.92; 3.83] years), and 29 (60%) returned the survey. Eleven patients out of 29 (38%) recovered to baseline functioning, and reported higher HRQoL compared to unrecovered patients (0.861 [0.807; 1.000] and 0.753 [0.499; 0.779] respectively, p=0.005). Of the unrecovered patients, 53% were satisfied with their functioning, and 94% were willing to return to ICU.

Conclusions: Mortality in elderly patients with abdominal sepsis is high and ICU-admission should be weighed carefully. However, despite substantial functional decline in survivors, it does not necessarily cause self-perceived unsatisfactory functioning, poor HRQoL and unwillingness to receive life-sustaining therapy again. Caution is advised to use an anticipated loss of functioning as an argument to deny an ICU-admission.

Keywords: Elderly; ICU-admission; abdominal sepsis; functional outcome; health-related quality of life; shared decision-making.

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Figures

Figure 1.
Figure 1.
Patient inclusion flow chart
Figure 2.
Figure 2.
Survival rates: (A) overall survival from ICU-admission onwards; (B) survival after hospital discharge
Figure 3.
Figure 3.
Health-related quality of life, compared to age- and gender matched reference population. A: EQ-5D-3L summary index scores. B: EQ-VAS scores.
Figure 4.
Figure 4.
Percentage of patients reporting any problem within the separate EQ5D domains, * p=0.003, ** p=0.007.
See this image and copyright information in PMC

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