Evaluation of quality of life in patient over 70 years with multiorgan failure requiring mechanical ventilation and/or continuous renal replacement therapies

Abstract

Introduction: A very high percentage of patients in Intensive Care Units are ≥ 70 years. The need to assess health status in these patients has led to develop different tools or questionnaires to ascertain the quality of life after hospital discharge. Objetives: To assess the quality of life by measuring scales in elderly patients with multiple organ failure (MOF) and the patients with Limited Care (LC) and your perception of quality of life. Material and methods: Prospective 6-month follow-up patients admitted to the ICU with age ≥ 70 years and with MOF (SOFA≥3). Quality of life Related to Health (HRQOL) was documented at discharge and at 6 months with Health Status Questionnaire SF_36 and the Barthel Index. At 6 months, they received information about Living Wills. Other variables: age, sex, SAPS II, SOFA admission, Charlson Index, Sabadell Score, hospital and ICU stay and mortality Results: We studied 26 patients and SOFA ≥ 3. 15 were alive at 6 months, 7 died, 2 left and 1 patients was transferred to the Community. The mean age was 78 years. 66,7 % were men. 73% had poor quality of life at admission (SF_36 ≤ 50). 60% of all patients need invasive ventilation, 60% non invasive ventilation and 14% haemodialysis. The hospital stay was correlated with physical role (r=0,427, p=0,042), emotional role (r=0,497, p=0,013) bodily pain (r=0,516, p=0,014) and mental health (r=0,488, p=0,016). Of the 8 patients with LC, 5 were live at 6 months. These patients observed a decrease in quality of life. 86% of the all patients knew the meaning of your critical illness. 53% patients knew of the existence of the Living Wills although non patient was interested in your application. Conclusion: Most of the patients perceive a quality of life at 6 months equal or higher than the prior at admission ICU. All patients discharged with LC, at 6 months presented a lower quality of life. The Sabadell Score correlates with the social function and vitality at 6 months. No patient was interested in the drafting of the Living Wills.