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Association between frailty and short- and long-term outcomes among critically ill patients: a multicentre prospective cohort study

Canadian Medical Association journal (CMAJ), 2014-02, Vol.186 (2), p.E95-E102 [Peer Reviewed Journal]

COPYRIGHT 2014 Joule Inc. ;Copyright Canadian Medical Association Feb 4, 2014 ;1995-2014, Canadian Medical Association 2014 ;ISSN: 0820-3946 ;EISSN: 1488-2329 ;DOI: 10.1503/cmaj.130639 ;PMID: 24277703 ;CODEN: CMAJAX

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  • Title:
    Association between frailty and short- and long-term outcomes among critically ill patients: a multicentre prospective cohort study
  • Author: Bagshaw, Sean M ; Stelfox, H Thomas ; McDermid, Robert C ; Rolfson, Darryl B ; Tsuyuki, Ross T ; Baig, Nadia ; Artiuch, Barbara ; Ibrahim, Quazi ; Stollery, Daniel E ; Rokosh, Ella ; Majumdar, Sumit R
  • Subjects: Aged ; Care and treatment ; Cohort Studies ; Critical Illness ; Critically ill ; Elder care ; Female ; Frail Elderly ; Frailty ; Humans ; Intensive care ; Male ; Medical prognosis ; Medical research ; Medicine, Experimental ; Patients ; Prognosis ; Prospective Studies ; Quality of life ; Severity of Illness Index ; Studies ; Time Factors
  • Is Part Of: Canadian Medical Association journal (CMAJ), 2014-02, Vol.186 (2), p.E95-E102
  • Description: Frailty is a multidimensional syndrome characterized by loss of physiologic and cognitive reserves that confers vulnerability to adverse outcomes. We determined the prevalence, correlates and outcomes associated with frailty among adults admitted to intensive care. We prospectively enrolled 421 critically ill adults aged 50 or more at 6 hospitals across the province of Alberta. The primary exposure was frailty, defined by a score greater than 4 on the Clinical Frailty Scale. The primary outcome measure was in-hospital mortality. Secondary outcome measures included adverse events, 1-year mortality and quality of life. The prevalence of frailty was 32.8% (95% confidence interval [CI] 28.3%-37.5%). Frail patients were older, were more likely to be female, and had more comorbidities and greater functional dependence than those who were not frail. In-hospital mortality was higher among frail patients than among non-frail patients (32% v. 16%; adjusted odds ratio [OR] 1.81, 95% CI 1.09-3.01) and remained higher at 1 year (48% v. 25%; adjusted hazard ratio 1.82, 95% CI 1.28-2.60). Major adverse events were more common among frail patients (39% v. 29%; OR 1.54, 95% CI 1.01-2.37). Compared with nonfrail survivors, frail survivors were more likely to become functionally dependent (71% v. 52%; OR 2.25, 95% CI 1.03-4.89), had significantly lower quality of life and were more often readmitted to hospital (56% v. 39%; OR 1.98, 95% CI 1.22-3.23) in the 12 months following enrolment. Frailty was common among critically ill adults aged 50 and older and identified a population at increased risk of adverse events, morbidity and mortality. Diagnosis of frailty could improve prognostication and identify a vulnerable population that might benefit from follow-up and intervention.
  • Publisher: Canada: Joule Inc
  • Language: English
  • Identifier: ISSN: 0820-3946
    EISSN: 1488-2329
    DOI: 10.1503/cmaj.130639
    PMID: 24277703
    CODEN: CMAJAX
  • Source: ProQuest One Psychology
    GFMER Free Medical Journals
    MEDLINE
    PubMed Central
    Alma/SFX Local Collection
    ProQuest Central
    DOAJ Directory of Open Access Journals
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