[Surgical intensive care in advanced age].

The question of sense and limits of intensive care in the critically ill or traumatized elderly induced us to analyse our own patients. In 1986, 877 patients were treated in our surgical intensive care unit. 164 (= 19%) of these patients were greater than or equal to 70 years old. Of these 22 had suffered a trauma, 142 were non-traumatized patients. 83 had an emergency operation, 76 an elective operation, and 5 were treated conservatively. Preoperative risk assessment was estimated, according to ASA classification. The median length of stay in the surgical intensive care unit was 2.9 days for all 877 patients, that of our patients greater than or equal to 70 years 1.9 days. Mortality in the intensive care unit was 6.5% for the whole group, and 6.1% for the group greater than or equal to 70 years of age. 79 of the 164 elderly patients (= 48%) could be discharged to their homes, 52 (= 32%) into another hospital, 4 (= 2.4%) were transferred to a nursing home, and 29 (= 17.7%) died during hospitalization. Two years after admission in the intensive care unit 84 (= 51%) patients were still alive. These patients looked rather optimistically on their state of health and independence, which allows certain conclusing on an acceptable quality of life. The results seem to justify an aggressive attitude regarding primary treatment of elderly patients, all the more since in the elderly feasibility of treating quite often becomes evident only after an attempt for treatment.