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- Title
Mortality in Relation to Frailty in Patients Admitted to a Specialized Geriatric Intensive Care Unit.
- Authors
An Zeng; Xiaowei Song; Jiahui Dong; Mitnitski, Arnold; Jian Liu; Zhenhui Guo; Rockwood, Kenneth; Zeng, An; Song, Xiaowei; Dong, Jiahui; Liu, Jian; Guo, Zhenhui
- Abstract
<bold>Background: </bold>In older adults admitted to intensive care units (ICUs), frailty influences prognosis. We examined the relationship between the frailty index (FI) based on deficit accumulation and early and late survival.<bold>Methods: </bold>Older patients (≥65 years) admitted to a specialized geriatric ICU at the Liuhuaqiao Hospital, Guangzhou, China between July-December 2011 (n = 155; age 82.7±7.1 y; 87.1% men) were followed for 300 days. The FI was calculated as the proportion present of 52 health deficits. FI performance was compared with that of several prognostic scores.<bold>Results: </bold>The 90-day death rate was 38.7% (n = 60; 27 died within 30 days). The FI score was correlated with the Glasgow Coma Scale, Karnofsky Scale, Palliative Performance Scale, Acute Physiology Score-APACHE II and APACHE IV (r (2) = 0.52 to 0.72, p < 0.001). Patients who died within 30 days had higher mean FI scores (0.41±0.11) than those who survived to 300 days (0.22±0.11; F = 38.91, p < 0.001). Each 1% increase in the FI from the previous level was associated with an 11% increase in the 30-day mortality risk (95% CI: 7%-15%) adjusting for age, sex, and the prognostic scores. The FI discriminated patients who died in 30 days from those who survived with moderately high accuracy (AUC = 0.89±0.03). No one with an FI score >0.46 survived past 90 days.<bold>Conclusion: </bold>ICU survival was strongly associated with the level of frailty at admission. An FI based on health deficit accumulation may help improve critical care outcome prediction in older adults.
- Subjects
GERIATRIC care units; CRITICAL care medicine; FRAIL elderly; SURVIVAL analysis (Biometry); PROGNOSIS; AKAIKE information criterion; PROPORTIONAL hazards models; GERIATRIC assessment; APACHE (Disease classification system); HOSPITAL admission &; discharge; INTENSIVE care units; LONGITUDINAL method; PATIENTS; RESEARCH funding; HOSPITAL mortality; KARNOFSKY Performance Status; GLASGOW Coma Scale
- Publication
Journals of Gerontology Series A: Biological Sciences & Medical Sciences, 2015, Vol 70, Issue 12, p1586
- ISSN
1079-5006
- Publication type
journal article
- DOI
10.1093/gerona/glv084