Cognitive, functional, and quality-of-life outcomes of patients aged 80 and older who survived at least 1 year after planned or unplanned surgery or medical intensive care treatment

J Am Geriatr Soc. 2008 May;56(5):816-22. doi: 10.1111/j.1532-5415.2008.01671.x. Epub 2008 Apr 1.


Objectives: To investigate long-term cognitive, functional, and quality-of-life outcomes in very elderly survivors at least 1 year after planned or unplanned surgery or medical intensive care treatment.

Design: Retrospective cohort study.

Setting: General, 1,024-bed, tertiary university teaching hospital in The Netherlands.

Participants: Two hundred four survivors of a cohort of 578 patients admitted to the medical-surgical intensive care unit (ICU) between January 1997 and December 2002 and alive in December 2003. The majority of survivors underwent elective surgery.

Measurements: From December 2003 until February 2004, data were collected from 190 patients and 169 relatives. The measures were: Informant Questionnaire on Cognitive Decline short form (IQCODE-SF) (cognition), modified Katz index of activities of daily living (ADLs) (functional status), and EuroQol (EQ-5D) (health-related quality of life). The patients themselves completed the modified Katz ADL index and EQ-5D forms; their caregivers completed the ADL caregiver version and IQCODE-SF.

Results: The mean age at admission+/-standard deviation was 81.7+/-2.4, and the median time after discharge was 3.7 years (range 1-5.9 years). Of the ICU patients who had planned surgery, 57% survived, compared with 11% of the unplanned surgical admissions and 10% of the medical patients. Three-quarters (74.3%) of the patients who lived at home before ICU admission remained at home at follow-up. Eighty-three percent had no severe cognitive impairment, and 76% had no severe physical limitations (33% had moderate, 40% had mild, and 3% had no limitations). The perceived quality of life was similar to that of an age-matched general population.

Conclusion: Long-term survivors of ICU treatment received at the age of 80 and older showed fair-to-good cognitive and physical functioning and quality of life, although few patients who underwent unplanned surgery or who were admitted to the ICU for medical reasons survived.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living / psychology*
  • Aged, 80 and over
  • Cognition Disorders / diagnosis*
  • Cognition Disorders / epidemiology
  • Cognition Disorders / psychology
  • Cohort Studies
  • Critical Care* / psychology
  • Female
  • Humans
  • Male
  • Outcome Assessment, Health Care / statistics & numerical data
  • Postoperative Complications / diagnosis*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / psychology
  • Quality of Life / psychology*
  • Retrospective Studies
  • Surgical Procedures, Operative* / psychology
  • Survivors* / psychology
  • Survivors* / statistics & numerical data