• Anaesthesiol Intensive Ther · Jan 2018

    Frailty is associated with an increased mortality among patients ≥ 80 years old treated in Polish ICUs

    • Jakub Fronczek, Kamil Jurand Polok, Ilona Nowak-Kózka, Anna Włudarczyk, Jacek Górka, Mirosław Czuczwar, Paweł Krawczyk, Mirosław Ziętkiewicz, Łukasz R Nowak, Maciej Żukowski, Katarzyna Kotfis, Katarzyna Cwyl, Ryszard Gajdosz, Romuald Bohatyrewicz, Jowita Biernawska, Paweł Grudzień, Paweł Nasiłowski, Natalia Popek, Waldemar Cyrankiewicz, Katarzyna Wawrzyniak, Marek Wnuk, Dariusz Maciejewski, Dorota Studzińska, Szymon Bernas, Mariusz Piechota, Waldemar Machała, Marta Serwa, Maria Wujtewicz, Jan Stefaniak, Małgorzata Szymkowiak, Ryszard Gawda, Barbara Adamik, Natalia Kozera, Waldemar Goździk, Hans Flaatten, and Wojciech Szczeklik.
    • Department of Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Cracow, Poland. wojciech.szczeklik@uj.edu.pl.
    • Anaesthesiol Intensive Ther. 2018 Jan 1; 50 (4): 245-251.

    BackgroundThe increasing population of very old intensive care patients (VIPs) is a major challenge currently faced by clinicians and policymakers. Reliable indicators of VIPs' prognosis and purposefulness of their admission to the intensive care unit (ICU) are urgently needed.MethodsThis is a report from the Polish sample of the VIP1 multicentre cohort study (NCT03134807). Patients ≥ 80 years of age admitted to the ICU were included in the study. Information on the type and reason for admission, demographics, utilisation of ICU procedures, ICU length of stay, organ dysfunction and the decision to apply end-of-life care was collected. The primary objective was to investigate the impact of frailty syndrome on ICU and 30-day survival of VIPs. Frailty was assessed with the Clinical Frailty Scale (≥ 5 points on a scale of 1-9).ResultsWe enrolled 272 participants with a median age of 84 (81-87) years. Frailty was diagnosed in 170 (62.5%) patients. The ICU and 30-day survival rates were equal to 54.6% and 47.3% respectively. Three variables were found to significantly increase the odds of death in the ICU in a multiple logistic regression model: SOFA score (OR = 1.16; 95%CI 1.16-1.24), acute mode of admission (OR = 5.1; 95%CI 1.67-15.57) and frailty (OR = 2.25; 95%CI 1.26-4.01).ConclusionMeasuring frailty in critically ill older adults can facilitate making more informed clinical decisions and help avoid futile interventions.

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