Relationship between the Clinical Frailty Scale and short-term mortality in patients ≥ 80 years old acutely admitted to the ICU : a prospective cohort study
Fronczek, Jakub (Jagiellonian University Medical College)
Polok, Kamil (Jagiellonian University Medical College)
De Lange, Dylan W.. (University Utrecht)
Jung, Christian (University Hospital of Düsseldorf (Alemanya))
Beil, Michael (Hadassah Medical Center. Medical Intensive Care Unit)
Rhodes, Andrew (St George's University Hospitals NHS Foundation Trust)
Fjølner, Jesper (Aarhus University Hospital (Aarhus, Dinamarca))
Górka, Jacek (Jagiellonian University Medical College)
Andersen, Finn H. (Ålesund Hospital)
Artigas Raventós, Antoni (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Cecconi, Maurizio (Humanitas University (Alemanya))
Christensen, Steffen (Aarhus University Hospital (Aarhus, Dinamarca))
Joannidis, Michael (Medical University Innsbruck)
Leaver, Susannah (Research Lead Critical Care Directorate St George's Hospital)
Marsh, Brian (Mater Misericordiae University Hospital(Dublín, Irlanda))
Morandi, Alessandro (Hospital Ancelle di Cremona Italy)
Moreno, Rui (Centro Hospitalar Universitário de Lisboa Central)
Oeyen, Sandra (Universitair Ziekenhuis Gent)
Agvald-Öhman, Christina (Karolinska University Hospital and Karolinska Institutet (Suècia))
Bollen Pinto, Bernardo (Geneva University Hospitals (Suïssa))
Schefold, Joerg C. (Bern University Hospital)
Valentin, Andreas (Kardinal Schwarzenberg Hospital (Àustria))
Walther, Sten (Linköping University)
Watson, Ximena (St George's University Hospitals NHS Foundation Trust)
Zafeiridis, Tilemachos (General University Hospital of Larissa (Grècia))
Sviri, Sigal (Hebrew University of Jerusalem)
van Heerden, Peter Vernon (Hebrew University of Jerusalem)
Flaatten, Hans (University of Bergen)
Guidet, Bertrand (Institut Pierre Louis d'Epidémiologie et de Santé Publique)
Szczeklik, Wojciech (Jagiellonian University Medical College)
Universitat Autònoma de Barcelona

Data:	2021
Resum:	The Clinical Frailty Scale (CFS) is frequently used to measure frailty in critically ill adults. There is wide variation in the approach to analysing the relationship between the CFS score and mortality after admission to the ICU. This study aimed to evaluate the influence of modelling approach on the association between the CFS score and short-term mortality and quantify the prognostic value of frailty in this context. We analysed data from two multicentre prospective cohort studies which enrolled intensive care unit patients ≥ 80 years old in 26 countries. The primary outcome was mortality within 30-days from admission to the ICU. Logistic regression models for both ICU and 30-day mortality included the CFS score as either a categorical, continuous or dichotomous variable and were adjusted for patient's age, sex, reason for admission to the ICU, and admission Sequential Organ Failure Assessment score. The median age in the sample of 7487 consecutive patients was 84 years (IQR 81-87). The highest fraction of new prognostic information from frailty in the context of 30-day mortality was observed when the CFS score was treated as either a categorical variable using all original levels of frailty or a nonlinear continuous variable and was equal to 9% using these modelling approaches (p < 0. 001). The relationship between the CFS score and mortality was nonlinear (p < 0. 01). Knowledge about a patient's frailty status adds a substantial amount of new prognostic information at the moment of admission to the ICU. Arbitrary simplification of the CFS score into fewer groups than originally intended leads to a loss of information and should be avoided. Trial registration NCT03134807 (VIP1), NCT03370692 (VIP2) The online version contains supplementary material available at 10. 1186/s13054-021-03632-3.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Intensive care units ; Aged, 80 and over ; Frailty ; Prospective studies ; Mortality
Publicat a:	Critical Care, Vol. 25 (july 2021) , ISSN 1466-609X

DOI: 10.1186/s13054-021-03632-3
PMID: 34210358

9 p, 1.2 MB

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d’Investigació i Innovació Parc Taulí (I3PT)
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