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The Impact of Frailty on ICU and 30-Day Mortality and the Level of Care in Very Elderly Patients (≥ 80 Years)

2017-12Journal article Open access
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dc.contributor.authorFlaatten, H
dc.contributor.authorDe Lange, DW
dc.contributor.authorMorandi, A
dc.contributor.authorAndersen, FH
dc.contributor.authorArtigas, A
dc.contributor.authorBertolini, G
dc.contributor.authorBoumendil, A
dc.contributor.authorCecconi, M
dc.contributor.authorChristensen, S
dc.contributor.authorFaraldi, L
dc.contributor.authorFjølner, J
dc.contributor.authorJung, C
dc.contributor.authorMarsh, B
dc.contributor.authorMoreno, R
dc.contributor.authorOeyen, S
dc.contributor.authorÖhman, C
dc.contributor.authorPinto, B
dc.contributor.authorSoliman, I
dc.contributor.authorSzczeklik, W
dc.contributor.authorValentin, A
dc.contributor.authorWatson, X
dc.contributor.authorZaferidis, T
dc.contributor.authorGuidet, B
dc.date.accessioned2019-11-27T15:45:01Z
dc.date.available2019-11-27T15:45:01Z
dc.date.issued2017-12
dc.description.abstractPURPOSE: Very old critical ill patients are a rapid expanding group in the ICU. Indications for admission, triage criteria and level of care are frequently discussed for such patients. However, most relevant outcome studies in this group frequently find an increased mortality and a reduced quality of life in survivors. The main objective was to study the impact of frailty compared with other variables with regards to short-term outcome in the very old ICU population. METHODS: A transnational prospective cohort study from October 2016 to May 2017 with 30 days follow-up was set up by the European Society of Intensive Care Medicine. In total 311 ICUs from 21 European countries participated. The ICUs included the first consecutive 20 very old (≥ 80 years) patients admitted to the ICU within a 3-month inclusion period. Frailty, SOFA score and therapeutic procedures were registered, in addition to limitations of care. For measurement of frailty the Clinical Frailty Scale was used at ICU admission. The main outcomes were ICU and 30-day mortality and survival at 30 days. RESULTS: A total of 5021 patients with a median age of 84 years (IQR 81-86 years) were included in the final analysis, 2404 (47.9%) were women. Admission was classified as acute in 4215 (83.9%) of the patients. Overall ICU and 30-day mortality rates were 22.1% and 32.6%. During ICU stay 23.8% of the patients did not receive specific ICU procedures: ventilation, vasoactive drugs or renal replacement therapy. Frailty (values ≥ 5) was found in 43.1% and was independently related to 30-day survival (HR 1.54; 95% CI 1.38-1.73) for frail versus non-frail. CONCLUSIONS: Among very old patients (≥ 80 years) admitted to the ICU, the consecutive classes in Clinical Frailty Scale were inversely associated with short-term survival. The scale had a very low number of missing data. These findings provide support to add frailty to the clinical assessment in this patient group.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationIntensive Care Med. 2017 Dec;43(12):1820-1828.pt_PT
dc.identifier.doi10.1007/s00134-017-4940-8pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3371
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSpringerpt_PT
dc.subjectAged, 80 and overpt_PT
dc.subjectCritical Illnesspt_PT
dc.subjectEuropept_PT
dc.subjectEuthanasia, Passivept_PT
dc.subjectFemalept_PT
dc.subjectFrail Elderlypt_PT
dc.subjectFrailtypt_PT
dc.subjectGeriatric Assessmentpt_PT
dc.subjectHumanspt_PT
dc.subjectIntensive Care Unitspt_PT
dc.subjectLength of Staypt_PT
dc.subjectMalept_PT
dc.subjectOutcome Assessment (Health Care)pt_PT
dc.subjectProportional Hazards Modelspt_PT
dc.subjectProspective Studiespt_PT
dc.subjectQuality of Lifept_PT
dc.subjectSeverity of Illness Indexpt_PT
dc.subjectTime Factorspt_PT
dc.subjectHospital Mortalitypt_PT
dc.subjectHSJ UCIpt_PT
dc.titleThe Impact of Frailty on ICU and 30-Day Mortality and the Level of Care in Very Elderly Patients (≥ 80 Years)pt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage1828pt_PT
oaire.citation.issue12pt_PT
oaire.citation.startPage1820pt_PT
oaire.citation.titleIntensive Care Medicinept_PT
oaire.citation.volume43pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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