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Relationship between the Clinical Frailty Scale and short-term mortality in patients ≥ 80 years old acutely admitted to the ICU

2021-07-01Artigo científico Acesso aberto
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dc.contributor.authorFronczek, Jakub
dc.contributor.authorPolok, Kamil
dc.contributor.authorde Lange, Dylan W.
dc.contributor.authorJung, Christian
dc.contributor.authorBeil, Michael
dc.contributor.authorRhodes, Andrew
dc.contributor.authorFjølner, J.
dc.contributor.authorGórka, Jacek
dc.contributor.authorAndersen, Finn H.
dc.contributor.authorArtigas, Antonio
dc.contributor.authorCecconi, Maurizio
dc.contributor.authorChristensen, Steffen
dc.contributor.authorJoannidis, Michael
dc.contributor.authorLeaver, Susannah
dc.contributor.authorMarsh, Brian
dc.contributor.authorMorandi, Alessandro
dc.contributor.authorMoreno, Rui
dc.contributor.authorOeyen, S.
dc.contributor.authorAgvald-Öhman, Christina
dc.contributor.authorBollen Pinto, B.
dc.contributor.authorSchefold, J. C.
dc.contributor.authorValentin, Andreas
dc.contributor.authorWalther, Sten
dc.contributor.authorWatson, Ximena
dc.contributor.authorZafeiridis, Tilemachos
dc.contributor.authorZafeiridis, Tilemachos
dc.contributor.authorSviri, Sigal
dc.contributor.authorvan Heerden, Peter Vernon
dc.contributor.authorFlaatten, Hans
dc.contributor.authorGuidet, Bertrand
dc.contributor.authorSzczeklik, Wojciech
dc.contributor.authorSchmutz, R.
dc.contributor.authorWimmer, F.
dc.contributor.authorEller, P.
dc.contributor.authorJoannidis, M.
dc.contributor.authorDe Buysscher, P.
dc.contributor.authorDe Neve, N.
dc.contributor.authorOeyen, S.
dc.contributor.authorSwinnen, W.
dc.contributor.authorBollen Pinto, B.
dc.contributor.authorAbraham, P.
dc.contributor.authorHergafi, L.
dc.contributor.authorSchefold, J. C.
dc.contributor.authorBiskup, E.
dc.contributor.authorPiza, P.
dc.contributor.authorTaliadoros, I.
dc.contributor.authorFjølner, J.
dc.contributor.authorDey, N.
dc.contributor.authorSølling, C.
dc.contributor.authorRasmussen, B. S.
dc.contributor.authorFerreira, I. A.
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.pblBioMed Central (BMC)
dc.date.accessioned2021-07-23T22:20:31Z
dc.date.available2021-07-23T22:20:31Z
dc.date.issued2021-07-01
dc.descriptionFunding Information: The members of VIP1 and VIP2 study groups are listed in Additional file 1 and are listed in their individual PubMed records. Publisher Copyright: © 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
dc.description.abstractBackground: 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. Methods: 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. Results: 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). Conclusion: 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)en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent1265291
dc.identifier.doi10.1186/s13054-021-03632-3
dc.identifier.issn1364-8535
dc.identifier.otherPURE: 32497284
dc.identifier.otherPURE UUID: 7fd56019-51bf-4bb7-b064-2287cddddcbf
dc.identifier.otherScopus: 85109183057
dc.identifier.otherPubMed: 34210358
dc.identifier.urihttp://hdl.handle.net/10362/121555
dc.identifier.urlhttps://www.scopus.com/pages/publications/85109183057
dc.language.isoeng
dc.peerreviewedyes
dc.subjectAged, 80 and over
dc.subjectFrailty
dc.subjectIntensive care units
dc.subjectMortality
dc.subjectProspective studies
dc.subjectCritical Care and Intensive Care Medicine
dc.titleRelationship between the Clinical Frailty Scale and short-term mortality in patients ≥ 80 years old acutely admitted to the ICUen
dc.title.subtitlea prospective cohort studyen
dc.typejournal article
degois.publication.issue1
degois.publication.titleCritical Care
degois.publication.volume25
dspace.entity.typePublication
person.familyNameZafeiridis
person.givenNameTilemachos
person.identifier.orcid0000-0001-5020-312X
rcaap.rightsopenAccess
relation.isAuthorOfPublication238e23ee-a9f7-42ef-8d52-6141abcebafe
relation.isAuthorOfPublication.latestForDiscovery238e23ee-a9f7-42ef-8d52-6141abcebafe

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