Frailty in patients over 65 years of age admitted to Intensive Care Units (FRAIL-ICU)

Cuenca, Sonia López; López, Loreto; Martín, N. Lázaro; Jaimes, M.M. Irazabal; Villamayor, Mercedes Ibarz; Artigas, Antonio; Balanza, José Ángel Lorente

doi:10.1016/j.medine.2019.01.007

Cited by 9 publications

(8 citation statements)

References 22 publications

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“…Table 1 ). Most of the included studies ( n = 40, 70.2%) were prospective cohort studies [ 2 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 ], followed by retrospective cohort studies ( n = 13, 21.1%) [ 10 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 ].…”

Section: Resultsmentioning

confidence: 99%

“…Another six studies ( n = 6, 10.3%) evaluated frailty according to the FFP [ 25 , 26 , 29 , 33 , 39 , 55 ], grading patients as robust (score of 0), intermediate-frail (score 1–2), and frail (score ≥3). Some studies used less frequently described instruments to measure frailty: Fisher et al [ 29 ] used the Dalhousie Frailty Scale (DCFS) and Darvall the Edmonton Frailty Scale (EFS) in two studies [ 44 , 48 ] and Lopez Cuenca et al [ 47 ], the Morley Frailty Scale [ 73 ].…”

Section: Resultsmentioning

confidence: 99%

“…For this purpose, Boumendil et al [22] used the Knauss classification [78] as based on physiological parameters. Some studies included cognition in their functional assessment, by using the Short Portable Mental Status Questionnaire (SPMSQ) [21] or Folstein's MMS [19], the cognitive score as component of Lawton-Brody IADL scale [23], the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) [10,34,46], the Clinical dementia rating scale (CDR) [47], or the Cognitive Performance Scale (CPS) [58]. Two studies added the nutritional status [27,47].…”

Section: Methods Of Frailty Assessment In the Critically Ill Andmentioning

confidence: 99%

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Methods of Assessing Frailty in the Critically Ill: A Systematic Review of the Current Literature

et al. 2022

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Introduction: As new treatments have become established, more frail pre-ICU patients are being admitted to intensive care units (ICUs); this is creating new challenges to provide adequate care and to ensure that resources are allocated in an ethical and economical manner. This systematic review evaluates the current standard for assessing frailty on the ICU, including methods of assessment, time point of measurements, and cut-offs. Methods: A systematic search was conducted on MEDLINE, Clinical Trials, Cochrane Library, and Embase. Randomized and non-randomized controlled studies were included that evaluated diagnostic tools and ICU outcomes for frailty. Exclusion criteria were the following: studies without baseline assessment of frailty on ICU admission, studies in paediatric patients or pregnant women, and studies that targeted very narrow populations of ICU patients. Eligible articles were included until January 31, 2021. Methodological quality was assessed using the Newcastle-Ottawa Scale. No meta-analysis was performed, due to heterogeneity. Results: N = 57 articles (253,376 patients) were included using 19 different methods to assess frailty or a surrogate. Frailty on ICU admission was most frequently detected using the Clinical Frailty Scale (CFS) (n = 35, 60.3%), the Frailty Index (n = 5, 8.6%), and Fried’s frailty phenotype (n = 6, 10.3%). N = 22 (37.9%) studies assessed functional status. Cut-offs, time points, and manner of baseline assessment of frailty on ICU admission varied widely. Frailty on ICU admission was associated with short- and long-term mortality, functional and cognitive impairment, increased health care dependency, and impaired quality of life post-ICU discharge. Conclusions: Frailty assessment on the ICU is heterogeneous with respect to methods, cut-offs, and time points. The CFS may best reflect frailty in the ICU. Frailty assessments should be harmonized and performed routinely in the critically ill.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Methods Of Frailty Assessment In the Critically Ill Andmentioning

confidence: 99%

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Methods of Assessing Frailty in the Critically Ill: A Systematic Review of the Current Literature

et al. 2022

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“…Similarly to our study, the reported prevalence of frailty in both European and non-European ICUs ranges between 20% and 35% or even up to 50% when limited to very old patients. 12,13,19,20…”

Section: Discussionmentioning

confidence: 99%

“…Frail patients have known palliative needs, which are expected to be exacerbated in critical illness. 11 Although several studies addressed frailty and PC in intensive care, 7,12 -14 there is scarce information on their relationship.…”

Section: Introductionmentioning

confidence: 99%

The PALliative MUlticenter Study in Intensive Care (PalMuSIC). Results From a Multicenter Study Addressing Frailty and Palliative Care Interventions in Intensive Care Units in Portugal

et al. 2021

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Introduction: Frailty is a clinically recognizable state of increased vulnerability common in critical medicine. When underrecognized, it may lead to invasive treatments that do not serve the patients’ best interest. Our aim was to evaluate the use of both palliative care consultation and invasive interventions in frail patients admitted to Intensive Care Units in Portugal. Methods: This was a prospective, observational study. All consecutive adult patients admitted for more than 24 h, over a 15-day period were enrolled. Twenty-three Portuguese Intensive Care Units were included. Informed consent was obtained from all patients or their surrogate. The doctor and nurse in charge calculated the Clinical Frailty Score as well as the reference family member Results: A total of 335 patients were included in the study (66% male). Mean age was 63.2 ± 16.8 and SAPS II score was 41.8 ± 17.4. Mean Clinical Frailty Score value was 3.5 ± 1.7. Frailty prevalence (mean score ≥ 5) was 20.9%. Frail patients were offered organ support therapy (64,3% invasive mechanical ventilation; 24,3% renal replacement therapy; 67,1% vasopressors) more often than non-frail patients. Nevertheless, limitation of therapeutic effort or a do not resuscitate order (p < 0.001) were more common in frail patients. Mortality rate by 6 months was higher among frail patients (50% vs. 32.3%, p < 0.001). Palliative Care was offered to only 15% of frail patients (3.9% overall). Conclusions: The authors suggest that palliative care should be universally consulted once frailty is identified in critical patients.

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Influencia de la fragilidad en el pronóstico de pacientes quirúrgicos mayores de 70 años con criterios de ingreso en UCI

et al. 2021

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Frailty in patients over 65 years of age admitted to Intensive Care Units (FRAIL-ICU)

Cited by 9 publications

References 22 publications

Methods of Assessing Frailty in the Critically Ill: A Systematic Review of the Current Literature

Methods of Assessing Frailty in the Critically Ill: A Systematic Review of the Current Literature

The PALliative MUlticenter Study in Intensive Care (PalMuSIC). Results From a Multicenter Study Addressing Frailty and Palliative Care Interventions in Intensive Care Units in Portugal

Influencia de la fragilidad en el pronóstico de pacientes quirúrgicos mayores de 70 años con criterios de ingreso en UCI

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