Prevalence and impact of frailty on mortality in elderly ICU patients: a prospective, multicenter, observational study
- 21 March 2014
- journal article
- research article
- Published by Springer Science and Business Media LLC in Intensive Care Medicine
- Vol. 40 (5), 674-682
- https://doi.org/10.1007/s00134-014-3253-4
Abstract
Frailty is a recent concept used for evaluating elderly individuals. Our study determined the prevalence of frailty in intensive care unit (ICU) patients and its impact on the rate of mortality. A multicenter, prospective, observational study performed in four ICUs in France included 196 patients aged ≥65 years hospitalized for >24 h during a 6-month study period. Frailty was determined using the frailty phenotype (FP) and the clinical frailty score (CFS). The patients were separated as follows: FP score p < 0.001], male gender (HR, 2.4; 95 % CI, 1.1–5.3; p = 0.026), cardiac arrest before admission (HR, 2.8; 95 % CI, 1.1–7.4; p = 0.036), SAPS II score ≥46 (HR, 2.6; 95 % CI, 1.2–5.3; p = 0.011), and brain injury before admission (HR, 3.5; 95 % CI, 1.6–7.7; p = 0.002). The risk factors for 6-month mortality were a CFS ≥5 (HR, 2.4; 95 % CI, 1.49–3.87; p < 0.001) and a SOFA score ≥7 (HR, 2.2; 95 % CI, 1.35–3.64; p = 0.002). An increased CFS was associated with significant incremental hospital and 6-month mortalities. Frailty is a frequent occurrence and is independently associated with increased ICU and 6-month mortalities. Notably, the CFS predicts outcomes more effectively than the commonly used ICU illness scores.Keywords
This publication has 43 references indexed in Scilit:
- Operationalization of Frailty Using Eight Commonly Used Scales and Comparison of Their Ability to Predict All‐Cause MortalityJournal of the American Geriatrics Society, 2013
- Variability of Intensive Care Admission Decisions for the Very ElderlyPLOS ONE, 2012
- Frailty predicts increased hospital and six-month healthcare cost following colorectal surgery in older adultsThe American Journal of Surgery, 2011
- Frailty in the critically ill: a novel conceptCritical Care, 2011
- Long-term outcome in medical patients aged 80 or over following admission to an intensive care unitCritical Care, 2011
- Pre-existing disease: the most important factor for health related quality of life long-term after critical illness: a prospective, longitudinal, multicentre trialCritical Care, 2010
- Frailty Among Community-Dwelling Elderly People in France: The Three-City StudyThe Journals of Gerontology: Series A, 2008
- Definitions for Sepsis and Organ Failure and Guidelines for the Use of Innovative Therapies in SepsisSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 1992
- A new method of classifying prognostic comorbidity in longitudinal studies: Development and validationJournal of Chronic Diseases, 1987
- APACHE IICritical Care Medicine, 1985