Frailty as a predictor of short-and long-term mortality in critically ill older medical patients
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https://doi.org/10.1016/j.jcrc.2019.10.018 |
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Title
Frailty as a predictor of short-and long-term mortality in critically ill older medical patientsAuthor (s)
Date
2019-01-01Publisher
ElsevierBibliographic citation
SILVA-OBREGÓN, J. Alberto, et al. Frailty as a predictor of short-and long-term mortality in critically ill older medical patients. Journal of critical care, 2020, vol. 55, p. 79-85.Type
info:eu-repo/semantics/articlePublisher version
https://www.sciencedirect.com/science/article/pii/S0883944119307956#!Version
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Abstract
Purpose
Frailty is a common condition among critically ill patients. Usually evaluated in a mixed population of medical, cardiac and surgical patients, we aimed to assess the impact of frailty on short- and long-term ... [+]
Purpose
Frailty is a common condition among critically ill patients. Usually evaluated in a mixed population of medical, cardiac and surgical patients, we aimed to assess the impact of frailty on short- and long-term mortality exclusively in critically ill older medical patients.
Materials and methods
We included 285 patients aged≥70 years admitted to ICU (2009–2017). Comorbidities, severity scores, treatment intensity and complications were recorded. Pre-hospital frailty, measured by Clinical Frailty Scale (CFS), was defined as a score ≥ 5 according to this scale.
Results
Prevalence of frailty (CFS ≥ 5) of 18.6%. Frail patients were more likely to be female (64.2% vs. 35.6%, p < .001) or suffer from heart failure (17% vs. 6%,p = .021). Apache II score was higher in frail than in non-frail patients (27.4 ± 7.1 vs. 24.8 ± 8.6,p = .041). Age, comorbidities, treatment intensity, complications, and ICU and hospital length of stay were similar between frail and non-frail patients. Life-sustaining treatment limitation was more frequent in frail patients (47.2% vs. 20.7%,p < .001). Except for ICU mortality, frailty was an independent predictor of short- and long-term mortality after adjustment for sociodemographic, comorbidities, severity scores, treatment intensity and complications.
Conclusions
Frailty (CFS ≥ 5) was independently associated with short- and long-term mortality in older patients admitted to ICU exclusively due to a medical reason. [-]
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© 2019 Elsevier Inc. All rights reserved.
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