Frailty in the age of VIPs (very old intensive care patients)

Montgomery, Carmel; Bagshaw, Sean M.

doi:10.1007/s00134-017-4974-y

Cited by 15 publications

(13 citation statements)

References 11 publications

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“…Adding information about the PFS to our prediction model significantly improved its predictive ability for 1-year mortality. This result, in addition to the results of other studies [4,15,31], suggests that prediction models could be improved by incorporating factors reflecting physiological age in addition to chronological age.…”

Section: Discussionsupporting

confidence: 63%

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Premorbid functional status as a predictor of 1-year mortality and functional status in intensive care patients aged 80 years or older

et al. 2018

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Section: Discussionsupporting

confidence: 63%

“…Chronological age is not itself a decisive factor for prognosis, but old age is frequently accompanied by frailty, which impairs the capacity to recover from a critical illness [4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Premorbid functional status as a predictor of 1-year mortality and functional status in intensive care patients aged 80 years or older

et al. 2018

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“…According to recent studies more complex scales assessing patients pre‐hospital status such as clinical frailty scale 37,38 could be more conclusive. In the study on frailty of very old intensive care patients, frail patients presented higher 30‐day mortality and they were more likely to have treatment limitation 39 . Furthermore, in the VIP 2 study clinical frailty scale alone was found to be an independent prognostic factor for 1‐month survival after ICU admission 40 .…”

Section: Discussionmentioning

confidence: 99%

Intensive care patient survival after limiting life‐sustaining treatment—The FINNEOL* national cohort study

Adamski

Weigl

Lahtinen

et al. 2020

Acta Anaesthesiol Scand

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The decision to limit life-sustaining treatment (LST) in the intensive care unit (ICU) is made when the patient's recovery is not anticipated, despite aggressive treatment. The practice of making such decisions in ICUs varies across geographical regions. 1 In some countries, endof-life practices are more common; a decision to withhold/withdraw LST has been reported in approximately 15% of ICU patients in the United States of America and Australia (range, 13%-18% and 12%-19%) and 11% in Europe (range 8%-15%). 2-4 In other countries, the practice is less frequent (eg 3% in South Asia) 2 and some regions do not have regulations regarding end-of-life care. 5 Decisions to limit LST are difficult because they are based on the subjective judgment of the treatment team, and these judgments can

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“…Recently, there has been a growing understanding that frailty may be a more robust predictor of vulnerability than chronological age alone [24]. Several studies have reported that frailty is associated with both poor short-term [2, 5, 25–27] and long-term [3, 4, 28–30] outcomes in patients in the ICU.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, several statements support the use of frailty in the triage [31–36], as an entrance to the ICU, while making decisions with respect to treatment limitations [37], as an exit from the ICU. Though there is a growing demand for bedside assessment of frailty [24], only a few scores have been developed for such acute care settings. Even the most widely investigated scores, such as Frailty Index [7] and CFS [8], require additional manual steps and training, which could be substantial hurdles against their implementation in acute settings.…”

Section: Discussionmentioning

confidence: 99%

Relationship between community walking ability and in-hospital mortality in elderly patients with sepsis: a single-center retrospective cohort study

et al. 2019

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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.

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Frailty in the age of VIPs (very old intensive care patients)

Cited by 15 publications

References 11 publications

Premorbid functional status as a predictor of 1-year mortality and functional status in intensive care patients aged 80 years or older

Premorbid functional status as a predictor of 1-year mortality and functional status in intensive care patients aged 80 years or older

Intensive care patient survival after limiting life‐sustaining treatment—The FINNEOL* national cohort study

Relationship between community walking ability and in-hospital mortality in elderly patients with sepsis: a single-center retrospective cohort study

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