Elders, triage and the intensivist

ABSTRACT

In France, the COVID-19 pandemic revealed the frailty of a health system that was considered unsinkable. Rationed for three decades, the human and material resources of our hospitals have been exhausted in less than two weeks, while those responsible for this precariousness and their successors were swaggering in the media. Caregivers then redoubled their efforts and initiatives to never abandon patients, sometimes to the detriment of their personal lives and their own health. The capacity of the intensive care units has been increased in proportion to the space and equipment available (especially respirators). The facilities and personnel of other specialties (operating rooms, technical platforms, intermediate care units) were also mobilized, leading to the deprogramming of surgical or exploratory procedures deemed non-urgent. As a result of the massive surge of patients and the scarcity of resources, the issue of access to critical care for the elderly has emerged early in the public debate. Apart from any controversy, well before the crisis, there was a body of scientific work evaluating the benefits or risks of a stay in intensive care for our elderly, according to specific medical criteria and a multidimensional approach to old age. © 2022 Elsevier Masson SAS