Purpose To examine the association of a simple frailty assessment, Life Space (LS), with in-hospital mortality in elderly patients with sepsis. Methods We used data from a single hospital between 2014 and 2017. We included elderly patients (age ≥ 65 years) admitted to the intensive care unit (ICU) with sepsis, as defined by sepsis-3 criteria. Frailty assessment was based on a patient’s ability to independently go out of the house before the ICU admission. We termed this dichotomous score as Life Space. The primary outcome was in-hospital mortality. Logistic regression was used to investigate the association of LS with each outcome after adjusting for age, sex, and Sequential Organ Failure Assessment score. Results Of the 335 participants included in the final analysis, 121 (36%) were classified as frail. LS-positive patients had a higher in-hospital mortality (adjusted odds ratio (aOR) 2.32; 95% confidence interval (CI) 1.36–3.96; P = 0.002) than did LS-negative patients. We observed similar patterns in six sets of sensitivity analyses after accounting for different confounders. In subgroup analyses, significant interactions were observed in participants with versus those without treatment limitations (aOR 1.02 vs. 2.66, P for interaction = 0.042). Conclusions In this single-center study, frailty assessed by LS was independently associated with a higher in-hospital mortality. Electronic supplementary material The online version of this article (10.1186/s40560-019-0385-1) contains supplementary material, which is available to authorized users.

Background The burden of COVID-19 on healthcare workers (HCWs) is reported to be increasing, yet the psychometric scales now in use evaluate only single aspects; few measure the pandemic-specific burden on HCWs comprehensively. Objective To develop a scale to quantify the physical, mental, and socioeconomic burden of the COVID-19 pandemic on HCWs. Design Scale development and cross-sectional survey. Participants Consenting HCWs aged ≥20. Main Measures Development of an item-list based on literature reviews and HCW panel input, evaluation of content validity and item selection using the Delphi method, psychometric testing conducted on HCWs, validity assessment by factor analyses and hypothesis verification, internal consistency evaluation by Cronbach’s alpha, test-retest analysis, and interpretability assessment. Key Results Through the Delphi process, a 29-item pilot scale was generated. In psychometric testing, data from 863 HCWs contributed to the development of the final version of this scale, called Pandemic Burden Index twenty for HCWs (PBI-20), a 20-item scale to measure six domains: fatigue, fear of infection, inadequacy as a medical professional, mental health concerns, prejudice or discrimination, and anxiety about one’s livelihood and daily life. Factor analysis showed each factor corresponded to the six domains of this scale. Hypothesis verification showed the PBI-20 total score to be moderately to highly correlated with the Short Form 36 vitality score and mental health score and with intention of turnover. The PBI-20 had good internal consistency (Cronbach’s alpha 0.92). Test-retest analysis showed the intraclass correlation coefficient to be 0.70 and the minimal important change to be −7.0. Conclusions The psychometrically sound questionnaire we developed to measure pandemic-specific burdens for HCWs provides an understanding of comprehensive burdens on HCWs and may serve to evaluate interventions to reduce the burdens. Supplementary Information The online version contains supplementary material available at 10.1007/s11606-023-08028-3.

OBJECTIVES: To investigate the relationship between ICU-acquired weakness (ICUAW) signatures and sepsis-related mortality using gene expression from the blood within 24 hours of sepsis onset. DESIGN: Observational study using differential gene expression analysis. SETTING: Publicly available gene expression profile GSE54514, single-center medical and surgical ICU. PATIENTS: Patients with primary bacteremia- and respiratory-triggered sepsis including 8 nonsurvivors and 13 survivors who were 18 years old and older and admitted to ICU. MEASUREMENTS AND MAIN RESULTS: Among validated 526 ICUAW gene signatures, differential gene expression analysis controlling for age identified 38 significantly expressed genes between nonsurvivors and survivors. Functional enrichment analysis of differentially expressed ICUAW genes identified impaired cadherin binding, sarcomere formation, and energy metabolism among nonsurvivors. CONCLUSIONS: Our findings demonstrated a biological association between sepsis-related mortality and ICUAW signatures in the early phase of sepsis. Defects in energy metabolism and muscle fiber formation were associated with sepsis-related mortality.

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