open access

Vol 50, No 4 (2018)
Original and clinical articles
Published online: 2018-09-21
Submitted: 2018-07-02
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Frailty increases mortality among patients ≥ 80 years old treated in Polish ICUs

Jakub Fronczek, Kamil Jurand Polok, Ilona Nowak-Kózka, Anna Włudarczyk, Jacek Górka, Mirosław Czuczwar, Paweł Krawczyk, Mirosław Ziętkiewicz, Łukasz R. Nowak, Maciej Żukowski, Katarzyna Kotfis, Katarzyna Cwyl, Ryszard Gajdosz, Romuald Bohatyrewicz, Jowita Biernawska, Paweł Grudzień, Paweł Nasiłowski, Natalia Popek, Waldemar Cyrankiewicz, Katarzyna Wawrzyniak, Marek Wnuk, Dariusz Maciejewski, Dorota Studzińska, Szymon Bernas, Mariusz Piechota, Waldemar Machała, Marta Serwa, Maria Wujtewicz, Jan Stefaniak, Małgorzata Szymkowiak, Ryszard Gawda, Barbara Adamik, Natalia Kozera, Waldemar Goździk, Hans Flaatten, Wojciech Szczeklik
DOI: 10.5603/AIT.a2018.0032
·
Pubmed: 30242826
·
Anaesthesiol Intensive Ther 2018;50(4):245-251.

open access

Vol 50, No 4 (2018)
Original and clinical articles
Published online: 2018-09-21
Submitted: 2018-07-02

Abstract

Background: The increasing population of very old intensive care patients (VIPs) is a major challenge currently faced by clinicians and policymakers. Reliable indicators of VIPs’ prognosis and purposefulness of their admission to the intensive care unit (ICU) are urgently needed. Methods: This is a report from the Polish sample of the VIP1 multicentre cohort study (NCT03134807). Patients ≥ 80 years of age admitted to the ICU were included in the study. Information on the type and reason for admission, demographics, utilisation of ICU procedures, ICU length of stay, organ dysfunction and the decision to apply end-of-life care was collected. The primary objective was to investigate the impact of frailty syndrome on ICU and 30-day survival of VIPs. Frailty was assessed with the Clinical Frailty Scale (≥ 5 points on a scale of 1–9). Results: We enrolled 272 participants with a median age of 84 (81–87) years. Frailty was diagnosed in 170 (62.5%) patients. The ICU and 30-day survival rates were equal to 54.6% and 47.3% respectively. Three variables were found to significantly increase the odds of death in the ICU in a multiple logistic regression model: SOFA score (OR = 1.16; 95%CI 1.16–1.24), acute mode of admission (OR = 5.1; 95%CI 1.67–15.57) and frailty (OR = 2.25; 95%CI 1.26–4.01). Conclusion: Measuring frailty in critically ill older adults can facilitate making more informed clinical decisions and help avoid futile interventions.

Abstract

Background: The increasing population of very old intensive care patients (VIPs) is a major challenge currently faced by clinicians and policymakers. Reliable indicators of VIPs’ prognosis and purposefulness of their admission to the intensive care unit (ICU) are urgently needed. Methods: This is a report from the Polish sample of the VIP1 multicentre cohort study (NCT03134807). Patients ≥ 80 years of age admitted to the ICU were included in the study. Information on the type and reason for admission, demographics, utilisation of ICU procedures, ICU length of stay, organ dysfunction and the decision to apply end-of-life care was collected. The primary objective was to investigate the impact of frailty syndrome on ICU and 30-day survival of VIPs. Frailty was assessed with the Clinical Frailty Scale (≥ 5 points on a scale of 1–9). Results: We enrolled 272 participants with a median age of 84 (81–87) years. Frailty was diagnosed in 170 (62.5%) patients. The ICU and 30-day survival rates were equal to 54.6% and 47.3% respectively. Three variables were found to significantly increase the odds of death in the ICU in a multiple logistic regression model: SOFA score (OR = 1.16; 95%CI 1.16–1.24), acute mode of admission (OR = 5.1; 95%CI 1.67–15.57) and frailty (OR = 2.25; 95%CI 1.26–4.01). Conclusion: Measuring frailty in critically ill older adults can facilitate making more informed clinical decisions and help avoid futile interventions.
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Keywords

frailty, intensive care units, medical futility, critical care

About this article
Title

Frailty increases mortality among patients ≥ 80 years old treated in Polish ICUs

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 50, No 4 (2018)

Pages

245-251

Published online

2018-09-21

DOI

10.5603/AIT.a2018.0032

Pubmed

30242826

Bibliographic record

Anaesthesiol Intensive Ther 2018;50(4):245-251.

Keywords

frailty
intensive care units
medical futility
critical care

Authors

Jakub Fronczek
Kamil Jurand Polok
Ilona Nowak-Kózka
Anna Włudarczyk
Jacek Górka
Mirosław Czuczwar
Paweł Krawczyk
Mirosław Ziętkiewicz
Łukasz R. Nowak
Maciej Żukowski
Katarzyna Kotfis
Katarzyna Cwyl
Ryszard Gajdosz
Romuald Bohatyrewicz
Jowita Biernawska
Paweł Grudzień
Paweł Nasiłowski
Natalia Popek
Waldemar Cyrankiewicz
Katarzyna Wawrzyniak
Marek Wnuk
Dariusz Maciejewski
Dorota Studzińska
Szymon Bernas
Mariusz Piechota
Waldemar Machała
Marta Serwa
Maria Wujtewicz
Jan Stefaniak
Małgorzata Szymkowiak
Ryszard Gawda
Barbara Adamik
Natalia Kozera
Waldemar Goździk
Hans Flaatten
Wojciech Szczeklik

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