Abstract：
BACKGROUND: The population worldwide is rapidly ageing, and demand for intensive care is increasing. People aged 85 years and above, known as the oldest old, are particularly vulnerable to critical illness owing to the physiological effects of ageing. Evidence surrounding admission of the oldest old to the intensive care is limited.
OBJECTIVE: The objective of this study was to systematically and comprehensively review and synthesise the published research investigating factors that influence decisions to admit the oldest old to the intensive care unit.
METHODS: This was a systematic review and narrative synthesis. Following a comprehensive search of CINAHL, Embase, and Medline databases, peer-reviewed primary research articles examining factors associated with admission or refusal to admit the oldest old to intensive care were selected. Data were extracted into tables and narratively synthesised.
RESULTS: Six studies met the inclusion criteria. Three studies identified factors associated with admission such as greater premorbid self-sufficiency, patient preferences, alignment between patient and physicians\' goals of treatment, age less than 85 years, and absence of cancer, or previous intensive care admission. Factors associated with refusal to admit were identified in all six studies and included limited or no bed availability, level of ICU physician experience, patients being deemed too ill or too well to benefit, and older age.
CONCLUSIONS: Published research investigating decision-making about admission or refusal to admit the oldest old to the intensive care unit is scant. The ageing population and increasing demand for intensive care unit resources has amplified the need for greater understanding of factors that influence decisions to admit or refuse admission of the oldest old to the intensive care unit. Such knowledge may inform guidelines regarding complex practice decisions about admission of the oldest old to an intensive care unit. Such guidelines would ensure the specialty needs of this population are considered and would reduce admission decisions that might disadvantage older people.
OBJECTIVE: The objective of this study was to systematically and comprehensively review and synthesise the published research investigating factors that influence decisions to admit the oldest old to the intensive care unit.
METHODS: This was a systematic review and narrative synthesis. Following a comprehensive search of CINAHL, Embase, and Medline databases, peer-reviewed primary research articles examining factors associated with admission or refusal to admit the oldest old to intensive care were selected. Data were extracted into tables and narratively synthesised.
RESULTS: Six studies met the inclusion criteria. Three studies identified factors associated with admission such as greater premorbid self-sufficiency, patient preferences, alignment between patient and physicians\' goals of treatment, age less than 85 years, and absence of cancer, or previous intensive care admission. Factors associated with refusal to admit were identified in all six studies and included limited or no bed availability, level of ICU physician experience, patients being deemed too ill or too well to benefit, and older age.
CONCLUSIONS: Published research investigating decision-making about admission or refusal to admit the oldest old to the intensive care unit is scant. The ageing population and increasing demand for intensive care unit resources has amplified the need for greater understanding of factors that influence decisions to admit or refuse admission of the oldest old to the intensive care unit. Such knowledge may inform guidelines regarding complex practice decisions about admission of the oldest old to an intensive care unit. Such guidelines would ensure the specialty needs of this population are considered and would reduce admission decisions that might disadvantage older people.
摘要：
背景：全球人口正在迅速老龄化，对重症监护的需求正在增加。85岁及以上的人，被称为最古老的老人，由于衰老的生理影响，特别容易患严重疾病。关于将最年长的老人送入重症监护的证据是有限的。
目的：本研究的目的是系统和全面地回顾和综合已发表的研究，这些研究调查了影响决定接纳年龄最大的老年人进入重症监护病房的因素。
方法：这是一个系统综述和叙述性综合。在对CINAHL进行全面搜索之后，Embase,和Medline数据库，我们选择了同行评审的主要研究文章,研究了与年龄最大的老年人入院或拒绝接受重症监护相关的因素.数据被提取到表格中，并以叙述方式进行综合。
结果：六项研究符合纳入标准。三项研究确定了与入院相关的因素，如更大的病前自给自足，患者偏好,患者和医生之间的治疗目标一致，年龄小于85岁，没有癌症，或以前的重症监护入院。在所有六项研究中都确定了与拒绝入院相关的因素，包括床位有限或没有床位。ICU医师经验水平，患者被认为病得太重或太好而无法受益，和老年。
结论：已发表的研究调查有关入院或拒绝将年龄最大的老年人送入重症监护病房的决策很少。人口老龄化和对重症监护病房资源的需求不断增加，因此需要更多地了解影响决定接纳或拒绝接纳年龄最大的老人进入重症监护病房的因素。这种知识可以为有关将最年长的老人送入重症监护病房的复杂实践决定的指南提供信息。这样的准则将确保考虑到该人群的专业需求，并减少可能不利于老年人的录取决定。
目的：本研究的目的是系统和全面地回顾和综合已发表的研究，这些研究调查了影响决定接纳年龄最大的老年人进入重症监护病房的因素。
方法：这是一个系统综述和叙述性综合。
结果：六项研究符合纳入标准。
结论：已发表的研究调查有关入院或拒绝将年龄最大的老年人送入重症监护病房的决策很少。
