ReviewAnnals of intensive care2024
Prognosticating the outcome of intensive care in older patients-a narrative review.
Review in Annals of intensive care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed.
- Mortality Predictions Including Pre-Admission Functional Status in ICU Patients With Delirium-A Substudy of the AID-ICU Trial.Acta anaesthesiologica Scandinavica · 2026Trial
- Intensive care under uncertainty: a qualitative study of how older patients and their relatives wish to contribute to decision-making.European geriatric medicine · 2026Observational
- Admission to intensive care: a matter of shared decision-making in the very old?European geriatric medicine · 2026Review
- Critical care of the very old, what needs to be done?European geriatric medicine · 2026Review
- End-of-life decision-making in very old critically ill patients.European geriatric medicine · 2026Review
- How prognostic information influences care planning in adult intensive care units: protocol for a realist review.BMJ open · 2026Article
- Five-year mortality and functional trajectories in older survivors of intensive care compared to the general population.Intensive care medicine · 2025Observational
- Prediction of Cardiopulmonary Resuscitation Outcomes for Arrest in Surgical Settings.JAMA network open · 2025Article
- [Medical decision-making in clinical disaster medicine and in healthcare crises : Applying ethics and law in resource allocation].Unfallchirurgie (Heidelberg, Germany) · 2025Article
- 'I am old, and I will rather abandon life with my eyes open': a qualitative study of Norwegians aged 80 and older explaining their intensive care unit admission preferences.Age and ageing · 2025Article
- Prognosis of Nonagenarian ICU Patients A Bayesian analysis of prospective European studies.Annals of intensive care · 2025Article
- Outcome Predictions at Two Time Points among Surrogates and Physicians of Mechanically Ventilated Patients.Critical care explorations · 2025Article
- ESICM consensus-based recommendations for the management of very old patients in intensive care.Intensive care medicine · 2025Article
- The role of artificial intelligence in life-sustaining treatment decisions: current state and future considerations.Intensive care medicine · 2025Article
- The (un)surprising resilience of octogenarians in intensive care.Intensive care medicine · 2025Article
- [Ethical boundary decisions in intensive care medicine].Innere Medizin (Heidelberg, Germany) · 2024Article
- Critical care beyond organ support: the importance of geriatric rehabilitation.Annals of intensive care · 2024Article
Corrections and comments
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Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Prognosis determines major decisions regarding treatment for critically ill patients. Statistical models have been developed to predict the probability of survival and other outcomes of intensive care. Although they were trained on the characteristics of large patient cohorts, they often do not represent very old patients (age ≥ 80 years) appropriately. Moreover, the heterogeneity within this particular group impairs the utility of statistical predictions for informing decision-making in very old individuals. In addition to these methodological problems, the diversity of cultural attitudes, available resources as well as variations of legal and professional norms limit the generalisability of prediction models, especially in patients with complex multi-morbidity and pre-existing functional impairments. Thus, current approaches to prognosticating outcomes in very old patients are imperfect and can generate substantial uncertainty about optimal trajectories of critical care in the individual. This article presents the state of the art and new approaches to predicting outcomes of intensive care for these patients. Special emphasis has been given to the integration of predictions into the decision-making for individual patients. This requires quantification of prognostic uncertainty and a careful alignment of decisions with the preferences of patients, who might prioritise functional outcomes over survival. Since the performance of outcome predictions for the individual patient may improve over time, time-limited trials in intensive care may be an appropriate way to increase the confidence in decisions about life-sustaining treatment.
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