The association of premorbid conditions with 6-month mortality in acutely admitted ICU patients over 80 years.
Activities of daily living
Cognitive functioning
Comorbidity
Critical care
Frailty
Outcome
Journal
Annals of intensive care
ISSN: 2110-5820
Titre abrégé: Ann Intensive Care
Pays: Germany
ID NLM: 101562873
Informations de publication
Date de publication:
30 Mar 2024
30 Mar 2024
Historique:
received:
11
08
2023
accepted:
08
01
2024
medline:
31
3
2024
pubmed:
31
3
2024
entrez:
30
3
2024
Statut:
epublish
Résumé
Premorbid conditions influence the outcome of acutely ill adult patients aged 80 years and over who are admitted to the ICU. The aim of this study was to determine the influence of such premorbid conditions on 6 month survival. Prospective cohort study in 242 ICUs from 22 countries including patients 80 years or above, admitted over a 6 months period to an ICU between May 2018 and May 2019. Only emergency (acute) ICU admissions in adult patients ≥ 80 years of age were eligible. Patients who were admitted after planned/elective surgery were excluded. We measured the Clinical Frailty Scale (CFS), the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), disability with the Katz activities of daily living (ADL) score, comorbidities and a Polypharmacy Score (CPS). Overall, the VIP2 study included 3920 patients. During ICU stay 1191 patients died (30.9%), and another 436 patients (11.1%) died after ICU discharge but within the first 30 days of admission, and an additional 895 patients died hereafter but within the first 6 months after admission (22.8%). The 6 months mortality was 64%. The median CFS was 4 (IQR 3-6). Frailty (CFS ≥ 5) was present in 26.6%. Cognitive decline (IQCODE above 3.5) was found in 30.2%. The median IQCODE was 3.19. A Katz ADL of 4 or less was present in 27.7%. Patients who surviving > 6 months were slightly younger (median age survivors 84 with IQR 81-86) than patients dying within the first 6 months (median age 84, IQR 82-87, p = 0.013), were less frequently frail (CFS > 5 in 19% versus 34%, p < 0.01) and were less dependent based on their Katz activities of daily living measurement (median Katz score 6, IQR 5-6 versus 6 points, IQR 3-6, p < 0.01). We found that Clinical Frailty Scale, age, and SOFA at admission were independent prognostic factors for 6 month mortality after ICU admission in patients age 80 and above. Adding other geriatric syndromes and scores did not improve the model. This information can be used in shared-decision making. gov: NCT03370692.
Sections du résumé
BACKGROUND
BACKGROUND
Premorbid conditions influence the outcome of acutely ill adult patients aged 80 years and over who are admitted to the ICU. The aim of this study was to determine the influence of such premorbid conditions on 6 month survival.
METHODS
METHODS
Prospective cohort study in 242 ICUs from 22 countries including patients 80 years or above, admitted over a 6 months period to an ICU between May 2018 and May 2019. Only emergency (acute) ICU admissions in adult patients ≥ 80 years of age were eligible. Patients who were admitted after planned/elective surgery were excluded. We measured the Clinical Frailty Scale (CFS), the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), disability with the Katz activities of daily living (ADL) score, comorbidities and a Polypharmacy Score (CPS).
RESULTS
RESULTS
Overall, the VIP2 study included 3920 patients. During ICU stay 1191 patients died (30.9%), and another 436 patients (11.1%) died after ICU discharge but within the first 30 days of admission, and an additional 895 patients died hereafter but within the first 6 months after admission (22.8%). The 6 months mortality was 64%. The median CFS was 4 (IQR 3-6). Frailty (CFS ≥ 5) was present in 26.6%. Cognitive decline (IQCODE above 3.5) was found in 30.2%. The median IQCODE was 3.19. A Katz ADL of 4 or less was present in 27.7%. Patients who surviving > 6 months were slightly younger (median age survivors 84 with IQR 81-86) than patients dying within the first 6 months (median age 84, IQR 82-87, p = 0.013), were less frequently frail (CFS > 5 in 19% versus 34%, p < 0.01) and were less dependent based on their Katz activities of daily living measurement (median Katz score 6, IQR 5-6 versus 6 points, IQR 3-6, p < 0.01).
CONCLUSIONS
CONCLUSIONS
We found that Clinical Frailty Scale, age, and SOFA at admission were independent prognostic factors for 6 month mortality after ICU admission in patients age 80 and above. Adding other geriatric syndromes and scores did not improve the model. This information can be used in shared-decision making.
CLINICALTRIALS
RESULTS
gov: NCT03370692.
Identifiants
pubmed: 38555336
doi: 10.1186/s13613-024-01246-w
pii: 10.1186/s13613-024-01246-w
doi:
Banques de données
ClinicalTrials.gov
['NCT03370692']
Types de publication
Journal Article
Langues
eng
Pagination
46Investigateurs
Philipp Eller
(P)
Raimund Helbok
(R)
René Schmutz
(R)
Joke Nollet
(J)
Nikolaas de Neve
(N)
Pieter De Buysscher
(P)
Walter Swinnen
(W)
Marijana Mikačić
(M)
Anders Bastiansen
(A)
Andreas Husted
(A)
Bård E S Dahle
(BES)
Christine Cramer
(C)
Christoffer Sølling
(C)
Dorthe Ørsnes Christensen
(DØ)
Jakob Edelberg Thomsen
(JE)
Jonas Juul Pedersen
(JJ)
Mathilde Hummelmose Enevoldsen
(MH)
Thomas Elkmann
(T)
Agnieszka Kubisz-Pudelko
(A)
Alan Pope
(A)
Amy Collins
(A)
Ashok S Raj
(AS)
Carole Boulanger
(C)
Christian Frey
(C)
Ciaran Hart
(C)
Clare Bolger
(C)
Dominic Spray
(D)
Georgina Randell
(G)
Helder Filipe
(H)
Ingeborg D Welters
(ID)
Irina Grecu
(I)
Jane Evans
(J)
Jason Cupitt
(J)
Jenny Lord
(J)
Jeremy Henning
(J)
Joanne Jones
(J)
Jonathan Ball
(J)
Julie North
(J)
Kiran Salaunkey
(K)
Laura Ortiz-Ruiz De Gordoa
(LO)
Louise Bell
(L)
Madhu Balasubramaniam
(M)
Marcela Vizcaychipi
(M)
Maria Faulkner
(M)
McDonald Mupudzi
(M)
Megan Lea-Hagerty
(M)
Michael Reay
(M)
Michael Spivey
(M)
Nicholas Love
(N)
Nick Spittle
(N)
Nick Spittle
(N)
Nigel White
(N)
Patricia Williams
(P)
Patrick Morgan
(P)
Phillipa Wakefield
(P)
Rachel Savine
(R)
Reni Jacob
(R)
Richard Innes
(R)
Ritoo Kapoor
(R)
Sally Humphreys
(S)
Steve Rose
(S)
Susan Dowling
(S)
Tarkeshwari Mane
(T)
Tom Lawton
(T)
Vongayi Ogbeide
(V)
Waqas Khaliq
(W)
Yolanda Baird
(Y)
Antoine Romen
(A)
Arnaud Galbois
(A)
Christophe Vinsonneau
(C)
Cyril Charron
(C)
Didier Thevenin
(D)
Emmanuel Guerot
(E)
Guillaume Besch
(G)
Guillaume Savary
(G)
Hervé Mentec
(H)
Jean-Luc Chagnon
(JL)
Jean-Philippe Rigaud
(JP)
Jean-Pierre Quenot
(JP)
Jeremy Castaneray
(J)
Jérémy Rosman
(J)
Julien Maizel
(J)
Kelly Tiercelet
(K)
Lucie Vettoretti
(L)
Maud Mousset Hovaere
(MM)
Messika Messika
(M)
Michel Djibré
(M)
Nathalie Rolin
(N)
Philippe Burtin
(P)
Pierre Garcon
(P)
Saad Nseir
(S)
Xavier Valette
(X)
Christian Rabe
(C)
Eberhard Barth
(E)
Henning Ebelt
(H)
Kristina Fuest
(K)
Marcus Franz
(M)
Michael Horacek
(M)
Michael Schuster
(M)
Patrick Meybohm
(P)
Raphael Romano Bruno
(RR)
Sebastian Allgäuer
(S)
Simon Dubler
(S)
Stefan J Schaller
(SJ)
Stefan Schering
(S)
Stephan Steiner
(S)
Thorben Dieck
(T)
Tim Rahmel
(T)
Tobias Graf
(T)
Anastasia Koutsikou
(A)
Aristeidis Vakalos
(A)
Bogdan Raitsiou
(B)
Elli Niki Flioni
(EN)
Evangelia Neou
(E)
Fotios Tsimpoukas
(F)
Georgios Papathanakos
(G)
Giorgos Marinakis
(G)
Ioannis Koutsodimitropoulos
(I)
Kounougeri Aikaterini
(K)
Nikoletta Rovina
(N)
Stylliani Kourelea
(S)
Tasioudis Polychronis
(T)
Vasiiios Zidianakis
(V)
Vryza Konstantinia
(V)
Zoi Aidoni
(Z)
Catherine Motherway
(C)
Chris Read
(C)
Ignacio Martin-Loeches
(I)
Andrea Neville Cracchiolo
(AN)
Aristide Morigi
(A)
Italo Calamai
(I)
Stefania Brusa
(S)
Ahmed Elhadi
(A)
Ahmed Tarek
(A)
Ala Khaled
(A)
Hazem Ahmed
(H)
Wesal Ali Belkhair
(WA)
Alexander D Cornet
(AD)
Diederik Gommers
(D)
Dylan de Lange
(D)
Eva van Boven
(E)
Jasper Haringman
(J)
Lenneke Haas
(L)
Lettie van den Berg
(L)
Oscar Hoiting
(O)
Peter Jager
(P)
Rik T Gerritsen
(RT)
Tom Dormans
(T)
Willem Dieperink
(W)
Alena Breidablik
(A)
Alena Breidablik
(A)
Anita Slapgard
(A)
Anne-Karin Rime
(AK)
Bente Jannestad
(B)
Britt Sjøbøe
(B)
Eva Rice
(E)
Finn H Andersen
(FH)
Hans Frank Strietzel
(HF)
Jan Peter Jensen
(JP)
Jørund Langørgen
(J)
Kirsti Tøien
(K)
Kristian Strand
(K)
Michael Hahn
(M)
Pål Klepstad
(P)
Aleksandra Biernacka
(A)
Anna Kluzik
(A)
Bartosz Kudlinski
(B)
Dariusz Maciejewski
(D)
Dorota Studzińska
(D)
Hubert Hymczak
(H)
Jan Stefaniak
(J)
Joanna Solek-Pastuszka
(J)
Joanna Zorska
(J)
Katarzyna Cwyl
(K)
Lukasz J Krzych
(LJ)
Maciej Zukowski
(M)
Małgorzata Lipińska-Gediga
(M)
Marek Pietruszko
(M)
Mariusz Piechota
(M)
Marta Serwa
(M)
Miroslaw Czuczwar
(M)
Mirosław Ziętkiewicz
(M)
Natalia Kozera
(N)
Paweł Nasiłowski
(P)
Paweł Sendur
(P)
Paweł Zatorski
(P)
Piotr Galkin
(P)
Ryszard Gawda
(R)
Urszula Kościuczuk
(U)
Waldemar Cyrankiewicz
(W)
Wojciech Gola
(W)
Alexandre Fernandes Pinto
(AF)
Ana Margarida Fernandes
(AM)
Ana Rita Santos
(AR)
Cristina Sousa
(C)
Inês Barros
(I)
Isabel Amorim Ferreira
(IA)
Jacobo Bacariza Blanco
(JB)
João Teles Carvalho
(JT)
Jose Maia
(J)
Nuno Candeias
(N)
Nuno Catorze
(N)
Vladislav Belskiy
(V)
Africa Lores
(A)
Angela Prado Mira
(AP)
Catia Cilloniz
(C)
David Perez-Torres
(D)
Emilio Maseda
(E)
Enver Rodriguez
(E)
Estefania Prol-Silva
(E)
Gaspar Eixarch
(G)
Gemma Gomà
(G)
Gerardo Aguilar
(G)
Gonzalo Navarro Velasco
(GN)
Marián Irazábal Jaimes
(MI)
Mercedes Ibarz Villamayor
(MI)
Noemí Llamas Fernández
(NL)
Patricia Jimeno Cubero
(PJ)
Sonia López-Cuenca
(S)
Teresa Tomasa
(T)
Anders Sjöqvist
(A)
Camilla Brorsson
(C)
Fredrik Schiöler
(F)
Henrik Westberg
(H)
Jessica Nauska
(J)
Joakim Sivik
(J)
Johan Berkius
(J)
Karin Kleiven Thiringer
(KK)
Lina De Geer
(L)
Filippo Boroli
(F)
Joerg C Schefold
(JC)
Leila Hergafi
(L)
Philippe Eckert
(P)
Ismail Yıldız
(I)
Ihor Yovenko
(I)
Richard Pugh
(R)
Informations de copyright
© 2024. The Author(s).
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