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Management and Outcomes of Intensive Care in the Geriatric Surgical Patient

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Principles and Practice of Geriatric Surgery

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Abstract

Should we admit geriatric patients to the intensive care unit (ICU) at all? Of course, we believe the answer to this question is a qualified “yes”; otherwise, our chapter would be brief indeed. But, it is important to remember that rationing health care based upon age has been advocated as a strategy for limiting cost [1]. Refusal of ICU admission is common across many developed countries and has been reported to range between 24 and 46% of requested admissions [2–6]. In these studies, advanced age and previously poor functional status are the most common reasons for refusal to admit to the ICU. In 2004, Sinuf and coworkers systematically reviewed rationing of ICU resources and found that age and severity of illness were most strongly associated with a refusal to admit to the ICU [7]. Admission to the ICU carries with it a large commitment of health care resources. If we admit geriatric patients, how do we best allocate costly and limited ICU resources? At a time when the numbers of geriatric ICU patients [8] and the costs associated with ICU care are rapidly increasing, it becomes important to examine what outcomes can be expected if we are to provide ICU care to elderly patients.

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Authors and Affiliations

  1. Department of Trauma Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Gary T. Marshall

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  1. Gary T. Marshall
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  2. Scott R. Gunn
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Correspondence to Gary T. Marshall .

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  1. School of Medicine, Department of Surgery, Yale University, New Haven, 06520, Connecticut, USA

    Ronnie Ann Rosenthal

  2. Downstate Medical Center, State University of New York, Clarkson Ave. 450, Brooklyn, 11203, New York, USA

    Michael E. Zenilman

  3. , Chairman, Department of Surgery, Sinai Hospital, 2401 West Belvedere Avenue, Baltimore, 21215, Maryland, USA

    Mark R. Katlic

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Marshall, G.T., Gunn, S.R. (2011). Management and Outcomes of Intensive Care in the Geriatric Surgical Patient. In: Rosenthal, R., Zenilman, M., Katlic, M. (eds) Principles and Practice of Geriatric Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-6999-6_30

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