The association of the Activities of Daily Living and the outcome of old intensive care patients suffering from COVID-19
Bruno, Raphael Romano (Heinrich-Heine-University Duesseldorf)
Wernly, Bernhard (Paracelsus Medical University Salzburg)
Flaatten, Hans (University of Bergen)
Fjølner, Jesper (Aarhus University Hospital (Aarhus, Dinamarca))
Artigas Raventós, Antoni (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Baldia, Philipp Heinrich (Heinrich-Heine-University Duesseldorf)
Binneboessel, Stephan (Heinrich-Heine-University Duesseldorf)
Bollen Pinto, Bernardo (Geneva University Hospitals (Suïssa))
Schefold, Joerg C. (University of Bern)
Wolff, Georg (Heinrich-Heine-University Duesseldorf)
Kelm, Malte (Heinrich-Heine-University Duesseldorf)
Beil, Michael (Hebrew University of Jerusalem)
Sviri, Sigal (Hebrew University of Jerusalem)
van Heerden, Peter Vernon (Hebrew University of Jerusalem)
Szczeklik, Wojciech (Jagiellonian University Medical College)
Elhadi, Muhammed (University of Tripoli)
Joannidis, Michael (Medical University Innsbruck)
Oeyen, Sandra (Universitair Ziekenhuis Gent)
Kondili, Eumorfia (University Hospital of Heraklion. Intensive Care Unit)
Marsh, Brian (Mater Misericordiae University Hospital(Dublín, Irlanda))
Wollborn, Jakob (Brigham and Women's Hospital (Boston, Estats Units d'Amèrica))
Andersen, Finn H. (Norwegian University of Science and Technology)
Moreno, Rui (Universidade da Beira Interior)
Leaver, Susannah (St George'S University Hospitals NHS Foundation Trust)
Boumendil, Ariane (Sorbonne Universités)
De Lange, Dylan W.. (University Utrecht)
Guidet, Bertrand (Hôpital Saint-Antoine (França))
Jung, Christian (Heinrich-Heine-University Duesseldorf)
Universitat Autònoma de Barcelona

Fecha:	2022
Resumen:	Critically ill old intensive care unit (ICU) patients suffering from Sars-CoV-2 disease (COVID-19) are at increased risk for adverse outcomes. This post hoc analysis investigates the association of the Activities of Daily Living (ADL) with the outcome in this vulnerable patient group. The COVIP study is a prospective international observational study that recruited ICU patients ≥ 70 years admitted with COVID-19 (NCT04321265). Several parameters including ADL (ADL; 0 = disability, 6 = no disability), Clinical Frailty Scale (CFS), SOFA score, intensive care treatment, ICU- and 3-month survival were recorded. A mixed-effects Weibull proportional hazard regression analyses for 3-month mortality adjusted for multiple confounders. This pre-specified analysis included 2359 patients with a documented ADL and CFS. Most patients evidenced independence in their daily living before hospital admission (80% with ADL = 6). Patients with no frailty and no disability showed the lowest, patients with frailty (CFS ≥ 5) and disability (ADL < 6) the highest 3-month mortality (52 vs. 78%, p < 0. 001). ADL was independently associated with 3-month mortality (ADL as a continuous variable: aHR 0. 88 (95% CI 0. 82-0. 94, p < 0. 001). Being "disable" resulted in a significant increased risk for 3-month mortality (aHR 1. 53 (95% CI 1. 19-1. 97, p 0. 001) even after adjustment for multiple confounders. Baseline Activities of Daily Living (ADL) on admission provides additional information for outcome prediction, although most critically ill old intensive care patients suffering from COVID-19 had no restriction in their ADL prior to ICU admission. Combining frailty and disability identifies a subgroup with particularly high mortality. Trial registration number: NCT04321265. The online version contains supplementary material available at 10. 1186/s13613-022-00996-9.
Derechos:	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.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Publicado en:	Annals of Intensive Care, Vol. 12 (march 2022) , ISSN 2110-5820

DOI: 10.1186/s13613-022-00996-9
PMID: 35303201

11 p, 2.2 MB

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Documentos de investigación > Documentos de los grupos de investigación de la UAB > Centros y grupos de investigación (producción científica) > Ciencias de la salud y biociencias > Instituto de Investigación e Innovación Parc Taulí (I3PT)
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