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Debido a las limitaciones de recursos disponibles y la divergencia en el resultado final de los pacientes muy ancianos (edad > 80 anos), estos son evaluados para valorar el pronostico y el beneficio antes de proceder a su admision en la UCI. Segun los estudios de poblacion es previsible un elevado aumento de pacientes de edad avanzada que requieran cuidados intensivos en un futuro proximo. Las decisiones de la admision deberian orientarse segun el pronostico determinado por la fragilidad y la comorbilidad, pero con un enfoque mas funcional. Siendo el indice de fragilidad un predictor independiente mas significativo que la edad, la gravedad de la enfermedad e incluso la comorbilidad. La fragilidad es multidimensional, pero implica caracteristicas cognitivas y de discapacidad que ayudan en la toma de decisiones para admitir a un paciente anciano en la UCI. El estudio ICE-CUB 1 y el reciente estudio ICE-CUB 2 se mantienen los mismos resultados e implica que es necesario evaluar los posibles beneficios y danos de la admision en la UCI de los pacientes muy ancianos. El presente articulo que solicito evaluen intenta orientar y ayudar para esa toma de decisiones en estos pacientes. ABSTRACT ICU challenges: elderly patient Due to the limitations of available resources and the divergence in the final result of very elderly patients (age> 80 years), these are evaluated to assess the prognosis and benefit before proceeding to their admission to the ICU. According to studies on population, a high increase in elderly patients requiring intensive care is foreseeable in the near future. Admission decisions should be oriented according to the prognosis determined by frailty and comorbidity, but with a more functional approach. Being the fragility index a more significant independent predictor than age, the severity of the disease and even comorbidity. Fragility is multidimensional, but it implies cognitive and physical characteristics that intervene in a decision-making process in order to admit elderly patients in the ICU.The ICE-CUB 1 study and the recent ICE-CUB 2 study reaffirm the same results and imply that it is necessary to evaluate the possible benefits and harms of the admission in the ICU of very elderly patients. The present article that I request an evaluation for is meant to be a guide for that decision-making process in these patients.

Retos en la UCI: El paciente muy anciano