부산대학교 도서관

Purpose Frailty is a recent concept used for evaluating elderly individuals. Our study determined the prevalence of frailty in intensive care unit (ICU) patients and its impact on the rate of mortality. Methods A multicenter, prospective, observational study performed in four ICUs in France included 196 patients aged [greater than or equal to]65 years hospitalized for >24 h during a 6-month study period. Frailty was determined using the frailty phenotype (FP) and the clinical frailty score (CFS). The patients were separated as follows: FP score Results Frailty was observed in 41 and 23 % of patients on the basis of an FP score [greater than or equal to]3 and a CFS [greater than or equal to]5, respectively. At admission to the ICU, the Simplified Acute Physiology Score II (SAPS II) and Sequential Organ Failure Assessment (SOFA) scores did not differ between the frail and nonfrail patients. In the multivariate analysis, the risk factors for ICU mortality were FP score [greater than or equal to]3 [hazard ratio (HR), 3.3; 95 % confidence interval (CI), 1.6-6.6; p < 0.001], male gender (HR, 2.4; 95 % CI, 1.1-5.3; p = 0.026), cardiac arrest before admission (HR, 2.8; 95 % CI, 1.1-7.4; p = 0.036), SAPS II score [greater than or equal to]46 (HR, 2.6; 95 % CI, 1.2-5.3; p = 0.011), and brain injury before admission (HR, 3.5; 95 % CI, 1.6-7.7; p = 0.002). The risk factors for 6-month mortality were a CFS [greater than or equal to]5 (HR, 2.4; 95 % CI, 1.49-3.87; p < 0.001) and a SOFA score [greater than or equal to]7 (HR, 2.2; 95 % CI, 1.35-3.64; p = 0.002). An increased CFS was associated with significant incremental hospital and 6-month mortalities. Conclusions Frailty is a frequent occurrence and is independently associated with increased ICU and 6-month mortalities. Notably, the CFS predicts outcomes more effectively than the commonly used ICU illness scores.
Author(s): Pascale Le Maguet [sup.1], Antoine Roquilly [sup.2], Sigismond Lasocki [sup.3], Karim Asehnoune [sup.2], Elsa Carise [sup.4], Marjorie Saint Martin [sup.3], Olivier Mimoz [sup.4] [sup.5] [sup.6], Grégoire Le Gac [sup.1], [...]