| Title |
Association of frailty with short-term outcomes, organ support and resource use in critically ill patients
|
|---|---|
| Published in |
Intensive Care Medicine, August 2018
|
| DOI | 10.1007/s00134-018-5342-2 |
| Pubmed ID | |
| Authors |
Fernando G. Zampieri, Theodore J. Iwashyna, Elizabeth M. Viglianti, Leandro U. Taniguchi, William N. Viana, Roberto Costa, Thiago D. Corrêa, Carlos Eduardo N. Moreira, Marcelo O. Maia, Giulliana M. Moralez, Thiago Lisboa, Marcus A. Ferez, Carlos Eduardo F. Freitas, Clayton B. de Carvalho, Bruno F. Mazza, Mariza F. A. Lima, Grazielle V. Ramos, Aline R. Silva, Fernando A. Bozza, Jorge. I. F. Salluh, Marcio Soares, for the ORCHESTRA Study Investigators |
| Abstract |
Frail patients are known to experience poor outcomes. Nevertheless, we know less about how frailty manifests itself in patients' physiology during critical illness and how it affects resource use in intensive care units (ICU). We aimed to assess the association of frailty with short-term outcomes and organ support used by critically ill patients. Retrospective analysis of prospective collected data from 93 ICUs in Brazil from 2014 to 2015. We assessed frailty using the modified frailty index (MFI). The primary outcome was in-hospital mortality. Secondary outcomes were discharge home without need for nursing care, ICU and hospital length of stay (LOS), and utilization of ICU organ support and transfusion. We used mixed logistic regression and competing risk models accounting for relevant confounders in outcome analyses. The analysis consisted of 129,680 eligible patients. There were 40,779 (31.4%) non-frail (MFI = 0), 64,407 (49.7%) pre-frail (MFI = 1-2) and 24,494 (18.9%) frail (MFI ≥ 3) patients. After adjusted analysis, frailty was associated with higher in-hospital mortality (OR 2.42, 95% CI 1.89-3.08), particularly in patients admitted with lower SOFA scores. Frail patients were less likely to be discharged home (OR 0.36, 95% CI 0.54-0.79) and had higher hospital and ICU LOS than non-frail patients. Use of all forms of organ support (mechanical ventilation, non-invasive ventilation, vasopressors, dialysis and transfusions) were more common in frail patients and increased as MFI increased. Frailty, as assessed by MFI, was associated with several patient-centered endpoints including not only survival, but also ICU LOS and organ support. |
X Demographics
The data shown below were collected from the profiles of 118 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 18 | 15% |
| United Kingdom | 16 | 14% |
| Australia | 7 | 6% |
| Canada | 5 | 4% |
| Spain | 5 | 4% |
| France | 5 | 4% |
| Colombia | 4 | 3% |
| Chile | 2 | 2% |
| Japan | 2 | 2% |
| Other | 17 | 14% |
| Unknown | 37 | 31% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 63 | 53% |
| Practitioners (doctors, other healthcare professionals) | 28 | 24% |
| Scientists | 22 | 19% |
| Science communicators (journalists, bloggers, editors) | 5 | 4% |
Mendeley readers
The data shown below were compiled from readership statistics for 117 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 117 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 18 | 15% |
| Student > Ph. D. Student | 15 | 13% |
| Student > Master | 10 | 9% |
| Student > Doctoral Student | 8 | 7% |
| Student > Bachelor | 8 | 7% |
| Other | 24 | 21% |
| Unknown | 34 | 29% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 45 | 38% |
| Nursing and Health Professions | 17 | 15% |
| Agricultural and Biological Sciences | 5 | 4% |
| Social Sciences | 4 | 3% |
| Computer Science | 2 | 2% |
| Other | 8 | 7% |
| Unknown | 36 | 31% |
Attention Score in Context
This research output has an Altmetric Attention Score of 64. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 30 May 2019.
All research outputs
#675,815
of 25,599,531 outputs
Outputs from Intensive Care Medicine
#619
of 5,444 outputs
Outputs of similar age
#14,305
of 341,816 outputs
Outputs of similar age from Intensive Care Medicine
#8
of 106 outputs
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