COURSE OF DISEASE AND PROGNOSIS OF NEUROL OGICAL INTENSIVE-CARE UNIT PATIENTS WITH SPECIAL RESPECT TO AGE

To evaluate risk factors effecting course and prognosis of neurologica l intensive care (ICU) patients with special respect to age, 422 patie nts (235 male, 187 female, mean age 56.7 years, standard deviation +/- 18.8 years) admitted to the ICU of the Department of Neurology, Unive rsity Erlangen-Nurnberg, were retrospectively studied. The status at t he time of ICU discharge was compared to that assessed 18 - 30 months later using the Barthel-Index, a five grade scale of independence, and the Glasgow Outcome Scale. At the time of reexamination, 203 of the 4 22 patients (48.2%) were still alive. The fatality rate increased with age. However, approximately 70% of the patients above the age of 70 y ears were still alive two years after ICU treatment with the majority of patients describing their life as satisfying. Multivariate analysis demonstrated that age by itself does not determine the course of dise ase. Age affects the prognosis only in combination with other variable s such as preexisting diseases (e.g. stroke, carotid surgery, occlusiv e arterial disease), secondary complications (e. g. pneumonia), and sp ecific ICU treatment (e. g. mechanical ventilation, nasogastric tube), and the patient's state at the time of ICU discharge (bedriddenness, aphasia, dementia).