The management of multi-morbidity in elderly patients: Ready yet for precision medicine in intensive care?
Michael Beil,
Hans Flaatten,
Bertrand Guidet,
Sigal Sviri,
Christian Jung,
Dylan de Lange,
Susannah Leaver,
Jesper Fjølner,
Wojciech Szczeklik,
Peter Vernon van Heerden
Affiliations
Michael Beil
Department of Medical Intensive Care, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem
Hans Flaatten
Department of Anaesthesia and Intensive Care Medicine, Haukeland University Hospital
Bertrand Guidet
Service de Reanimation, Hopital Saint-Antoine
Sigal Sviri
Department of Medical Intensive Care, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem
Christian Jung
Department of Cardiology, Pulmonology and Vascular Medicine, Faculty of Medicine, Heinrich-Heine-University Duesseldorf
Dylan de Lange
Department of Intensive Care Medicine, University Medical Center, University of Utrecht
Susannah Leaver
Department of Adult Critical Care, St George’s University Hospitals NHS Foundation Trust
Jesper Fjølner
Department of Intensive Care, Aarhus University Hospital
Wojciech Szczeklik
Center for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College
Peter Vernon van Heerden
General Intensive Care Unit, Department of Anesthesiology, Critical Care and Pain Medicine, Hadassah Medical Center and Faculty of Medicine, Hadassah University Hospital, Hebrew University of Jerusalem
Abstract There is ongoing demographic ageing and increasing longevity of the population, with previously devastating and often-fatal diseases now transformed into chronic conditions. This is turning multi-morbidity into a major challenge in the world of critical care. After many years of research and innovation, mainly in geriatric care, the concept of multi-morbidity now requires fine-tuning to support decision-making for patients along their whole trajectory in healthcare, including in the intensive care unit (ICU). This article will discuss current challenges and present approaches to adapt critical care services to the needs of these patients.
