Der alte Patient in der Intensivmedizin

Der demografische Wandel mit der Veränderung der Altersstruktur, hin zu älteren Menschen, und die Zunahme der chronischen Erkrankungen sowie der Fortschritt der Medizin führen dazu, dass immer mehr geriatrische Patienten intensivmedizinisch behandelt werden [1]. Diese Entwicklung stellt besondere Anforderungen an die medizinische Versorgung und das Management der Intensivpatienten im höheren Alter. Der Beitrag stellt die wichtigsten Aspekte vor.

Abstract

Demographic trends mean that the proportion of older and very old patients in hospitals at all levels of care is increasing. This means that significantly more patients from these age groups can be expected in the future. These developments pose new challenges for both medical care and the management of geriatric intensive care patients, taking into account their multimorbidity and functional limitations due to acute illness. Although mortality increases with age, the outcome is highly dependent on the patient's functionality and comorbidity. The elderly patient also shows structural and functional organ changes, knowledge of which is important for the treatment of geriatric patients in intensive care medicine. This increasing need for geriatric treatment will have a decisive influence on the development of intensive care medicine in the coming years.

Kernaussagen

• Die demografische Entwicklung führt dazu, dass der Anteil älterer und hochbetagter Patienten in den Krankenhäusern aller Versorgungsstufen zunimmt.

• Multimorbidität kennzeichnet den kritisch kranken geriatrischen Patienten.

• Alltagskompetenz und Funktionalität der Patienten vor der Intensivaufnahme sind von relevanter Bedeutung.

• Der ältere Patient zeigt strukturelle und funktionelle Organveränderungen, deren Kenntnisse für die Behandlung auf der Intensivmedizin von Bedeutung sind.

• Die klinische Frailty-Skala erlaubt eine Prognose-Abschätzung der intensivmedizinischen Behandlung bei geriatrischen Patienten.

• Das biologische Alter sollte für die Bewertung einer intensivmedizinischen Therapie nicht als alleiniger prognoserelevanter Risikofaktor betrachtet werden.

• Ältere Patienten sind bezüglich der Entwicklung eines Delirs besonders gefährdet.

Schlüsselwörter

Intensivmedizin - Geriatrie - Frailty - Multimorbidität - Delir

Keywords

intensive care medicine - geriatrics - frailty - multimorbidity - delirium

Publication History

Article published online:
12 February 2025

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