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

• Published in: Journal of intensive care medicine 2022-07, Vol.37 (7), p.970-978
• Main Authors: Cuijpers, Anne C.M., Coolsen, Marielle M.E., Schnabel, Ronny M., Lubbers, Tim, van der Horst, Iwan C.C., van Santen, Susanne, Olde Damink, Steven W.M., van de Poll, Marcel C.G.
• Format: Article
• Language: English
• Subjects: Original Research
• ISSN: 0885-0666; 1525-1489
• DOI: 10.1177/08850666211052460

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.