ArticleIntensive care medicine2025
ESICM consensus-based recommendations for the management of very old patients in intensive care.
Article in Intensive care medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 26 papers.
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Who cites it
26 citing papers in PubMed.
- Recognise, respond, reflect: A value-based framework for rapid response teams.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2026Article
- Medication Appropriateness and Potentially Inappropriate Medications in Older Critical Care Patients: A Scoping Review.Drugs & aging · 2026Review
- A hybrid multi-criteria decision-making framework for prioritising clinical determinants of medical futility in the intensive care unit.Journal of intensive care · 2026Article
- Admission to intensive care: a matter of shared decision-making in the very old?European geriatric medicine · 2026Review
- Patterns of medical intermediate care unit use in critically ill very old patients in France.European geriatric medicine · 2026Article
- Negotiating complexity in spite of scarce evidence-how to care for older ICU patients?Intensive care medicine · 2026Article
- Critical care of the very old, what needs to be done?European geriatric medicine · 2026Review
- Geriatric critical care assessment: key considerations.European geriatric medicine · 2026Review
- Creation of a dedicated post-intensive care geriatric unit (PIGU), proof of concept and preliminary results.European geriatric medicine · 2026Article
- Improving long-term trajectories in very old survivors of intensive care: a narrative review.European geriatric medicine · 2026Review
- Intensive care admissions in older adults: are we moving from ageism to ableism?European geriatric medicine · 2026Article
- Simulation study of frailty as a baseline confounder: the need to improve reporting intensive care trials.Critical care (London, England) · 2026Review
- Standard of care for rehabilitation in critical illness.Intensive care medicine · 2026Review
- Institutional Variation in Life-Sustaining Treatments and Mortality Among Older Patients.JAMA health forum · 2026Article
- [Intensive care of elderly patients : Core nursing responsibilities and central care priorities].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2026Review
- [82/f with hemodynamic instability and femoral neck fracture after a fall : Preparation for the medical specialist examination: part 30].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2026Article
- Skeletal Muscle Mass, Strength, and Functional Status in Critically Ill Older Adults Aged 60-75 and over 80 Years Old: An Exploratory Study.Healthcare (Basel, Switzerland) · 2026Article
- Access to and perceived value of post-ICU follow-up: an international cross-sectional survey of ICU professionals and adult critical illness survivors.Annals of intensive care · 2026Article
- Challenges and strategies in the care of older adults across the continuum of intensive and post-intensive care medicine.Intensive care medicine · 2026Review
- Characterizing ICU-like profiles of very old patients hospitalized in medical intermediate care units in France: A clustering analysis of a nationwide population-based study.Annals of intensive care · 2026Article
Corrections and comments
- Erratum issued
Authors and funding
32 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe heterogeneity of very old patients (age ≥ 80 years) and the prevalence of complex geriatric syndromes in this cohort constitute major challenges for the classical methods of evidence-based medicine to inform clinical practice. The lack of robust guidance for the management of critical conditions in these patients contributes to considerable uncertainty among practitioners and unwarranted variations of care. The European Society of Intensive Care Medicine (ESICM) initiated a Delphi study to translate the empirical knowledge of experts in this field into consensus-based recommendations for clinical practice.
methodsA multi-national group of specialists in intensive care, emergency, and geriatric medicine provided opinions on managing very old patients with critical conditions. Strong or moderate consensus was defined as having at least 90% or 80% of experts, respectively, expressing agreement or disagreement on the three highest or lowest levels of a 9-points Likert scale.
resultsTwenty-eight members of the expert steering group and 82 additional experts completed two Delphi rounds. After discussing the results, the steering group issued recommendations for 48 statements and 2 checklists for which consensus was achieved. In addition to determining fundamental principles, they include advice on goals of care and the decision-making about admission to and treatment of patients in intensive care and the management after discharge.
conclusionA multi-disciplinary group of experts achieved consensus on recommendations concerning intensive care for very old patients, which were approved and endorsed by ESICM. The implementation requires a careful analysis of available healthcare resources and should proceed in a stepwise fashion.
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