Turkish Journal of Geriatrics 2000 , Vol 3, Issue 4
ELDERLY PATIENT IN THE INTENSIVE CARE UNIT
Arzu TOPELÄ°
Hacettepe Üniversitesi Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, ANKARA Elderly patients admitted to the Intensive Care Unit (ICU) comprise a unique and quite complex patient group. Generally, elderly patients are admitted due to acute exacerbations of their underlying chronic health problems or are admitted because of problems related to multiple organ systems. Geriatric population is increasing daily. This increase in the geriatric population increases the proportion of critically-ill elderly patients who are in need of being admitted to the ICU, as well. Inasmuch as, one half of the ICU patients are elderly. The long-term morbidity, mortality, functional capacity and quality of life issues of the patients discharged from the ICU preserve their uncertainty. A serious problem occurring in the elderly patients manifests itself most of the time with atypical signs and symptoms which are different in the young. This might lead to a delay in the recognition of the disease. As we are faced with more critically-ill elderly patients together with increasing geriatric population, this subject has to be remembered. Delirium, fluid-electrolyte disorders, pressure ulcers and drug pharmacokinetics and dynamics constitute some of the problems which have to be specifically paid attention to. Although there are reports which reveal that as factors such as type of the treatment, underlying disease are standardized, elderly patients carry a bit worse prognosis than the young patients, contrary to the above mentioned view, there are views revealing that mortality or morbidity is dependent on the severity of the underlying disease, not the age. For this reason, withholding intensive treatment to a patient just because he or she is elderly is not appropriate, and the most appropriate care should be given by paying attention to the most frequent problems they are faced to and by paying attention to patient-rights in high dependency care units when necessary. Keywords : Elderly, Geriatrics, Intensive care unit, Intensive therapy, Critical ilness disease