The impact of frailty on death, discharge destination and modelling accuracy in patients receiving organ support on the intensive care unit.
APACHE II
death
discharge
frailty
intensive care
Journal
Journal of the Intensive Care Society
ISSN: 1751-1437
Titre abrégé: J Intensive Care Soc
Pays: England
ID NLM: 101538668
Informations de publication
Date de publication:
Feb 2023
Feb 2023
Historique:
entrez:
6
3
2023
pubmed:
7
3
2023
medline:
7
3
2023
Statut:
ppublish
Résumé
This study aims to identify any effect of frailty in altering the risk of death or poor outcome already associated with receipt of organ support on ICU. It also aims to assess the performance of mortality prediction models in frail patients. All admissions to a single ICU over 1-year were prospectively allocated a Clinical Frailty Score (CFS). Logistic regression analysis was used to investigate the effect of frailty on death or poor outcome (death/discharge to a medical facility). Logistic regression analysis, area under the Receiver Operator Curve (AUROC) and Brier scores were used to investigate the ability of two mortality prediction models, ICNARC and APACHE II, to predict mortality in frail patients. Of 849 patients, 700 (82%) patients were not frail, and 149 (18%) were frail. Frailty was associated with a stepwise increase in the odds of death or poor outcome (OR for each point rise of CFS = 1.23 ([1.03-1.47]; Frailty was associated with increased odds of death and poor outcome, but did not modify the risk already associated with organ support. Inclusion of frailty improved mortality prediction models.
Sections du résumé
Background
UNASSIGNED
This study aims to identify any effect of frailty in altering the risk of death or poor outcome already associated with receipt of organ support on ICU. It also aims to assess the performance of mortality prediction models in frail patients.
Methods
UNASSIGNED
All admissions to a single ICU over 1-year were prospectively allocated a Clinical Frailty Score (CFS). Logistic regression analysis was used to investigate the effect of frailty on death or poor outcome (death/discharge to a medical facility). Logistic regression analysis, area under the Receiver Operator Curve (AUROC) and Brier scores were used to investigate the ability of two mortality prediction models, ICNARC and APACHE II, to predict mortality in frail patients.
Results
UNASSIGNED
Of 849 patients, 700 (82%) patients were not frail, and 149 (18%) were frail. Frailty was associated with a stepwise increase in the odds of death or poor outcome (OR for each point rise of CFS = 1.23 ([1.03-1.47];
Conclusions
UNASSIGNED
Frailty was associated with increased odds of death and poor outcome, but did not modify the risk already associated with organ support. Inclusion of frailty improved mortality prediction models.
Identifiants
pubmed: 36874294
doi: 10.1177/17511437221096287
pii: 10.1177_17511437221096287
pmc: PMC9975794
doi:
Types de publication
Journal Article
Langues
eng
Pagination
16-23Informations de copyright
© The Intensive Care Society 2022.
Déclaration de conflit d'intérêts
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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