Current perspectives on defining and mitigating frailty in relation to critical illness

Costa, Nara Aline; Minicucci, Marcos F.; Pereira, Adriana Castreghini de Freitas; Paiva, Sérgio Alberto Rupp de; Okoshi, Marina Politi; Polegato, Bertha Furlan; Zornoff, Leonardo Antônio Mamede; Bôas, Paulo José Fortes Villas; Atherton, Philip J.; Piasecki, Mathew; Banerjee, Jay; Gordon, Adam; Azevedo, Paula Schmidt

doi:10.1016/j.clnu.2021.09.017

Cited by 4 publications

(4 citation statements)

References 88 publications

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“…Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA), and Trauma Injury Severity Scores (TRISS) were calculated to assess the severity of illness within 24 h of ICU admission. Frailty was assessed by the Clinical Frailty Scale (CFS), 21 which is a 9‐point scale that classifies patients along the continuum from very fit to terminally ill, with a score of >4 representing frailty and association with adverse outcomes in the ICU 22 . Clinical outcomes, such as acute respiratory distress syndrome (ARDS), pressure injures, and sepsis were recorded until discharge from the ICU following enrollment in the study.…”

Section: Methodsmentioning

confidence: 99%

“…Frailty was assessed by the Clinical Frailty Scale (CFS), 21 which is a 9-point scale that classifies patients along the continuum from very fit to terminally ill, with a score of >4 representing frailty and association with adverse outcomes in the ICU. 22 Clinical outcomes, such as acute respiratory distress syndrome (ARDS), pressure injures, and sepsis were recorded until discharge from the ICU following enrollment in the study. The number of days requiring mechanical ventilation, ICU and hospital length of stay, mortality, and ICU discharge location were recorded.…”

Section: Study Populationsmentioning

confidence: 99%

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Association between skeletal muscle changes, anthropometric measurements, and clinical outcomes in critically ill trauma and surgical patients: A prospective observational study

et al. 2022

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Background: Acute skeletal muscle wasting may predict clinical outcomes in critically ill patients. This study aimed to assess acute muscle loss, changes in anthropometric measurements, and the relationship between muscle loss and clinical outcomes in critically ill trauma and surgical patients.Methods: This single-center, prospective observational study was conducted in critically ill trauma and surgical patients who were expected to stay in the intensive care unit (ICU) for at least 7 days. Rectus femoris cross-sectional area muscle measurements were performed by bedside ultrasound, and anthropometric measurements were obtained at baseline and 7 days after the first assessment. Length of mechanical ventilation, ICU and hospital stay, and mortality were recorded. Results: Thirty-five patients with a mean age of 49.6 ± 18.6 years and 74.1% male were enrolled. The rectus femoris cross-sectional area, mid-arm circumference, and calf circumference were reduced at second assessment from baseline (P < 0.05). In univariate analysis, muscle loss and changes in anthropometric measurements were not associated with 90-day mortality (P > 0.05). Conclusion:Muscle loss in critical trauma and surgical patients occurred rapidly during the first week of critical illness. Rectus femoris muscle crosssectional area assessment can be used to detect skeletal muscle changes in critically ill patients. Further investigations on the skeletal muscle changes and clinical outcomes need to be conducted.

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Section: Methodsmentioning

confidence: 99%

Section: Study Populationsmentioning

confidence: 99%

Association between skeletal muscle changes, anthropometric measurements, and clinical outcomes in critically ill trauma and surgical patients: A prospective observational study

et al. 2022

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“…Because pre-illness frailty has been shown to be associated with loss of function, 46 the importance of frailty assessment is increasingly recognized. 47 Our results suggest that frailty assessment may also be important for identifying patients at high risk of acute skeletal muscle loss.…”

Section: Discussionmentioning

confidence: 69%

“…Furthermore, our study revealed that frailty was an independent predictor of acute skeletal muscle loss in multivariable‐adjusted analysis. Because pre‐illness frailty has been shown to be associated with loss of function, 46 the importance of frailty assessment is increasingly recognized 47 . Our results suggest that frailty assessment may also be important for identifying patients at high risk of acute skeletal muscle loss.…”

Section: Discussionmentioning

confidence: 75%

Nutrition determinants of acute skeletal muscle loss in critically ill patients: A prospective observational cohort study

Kangalgil,

Küçük,

Ulusoy

et al. 2023

Nut in Clin Prac

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BackgroundSkeletal muscle loss is associated with adverse outcomes in critically ill patients and risk factors of acute skeletal muscle loss are not well described. This study aims to determine the factors associated with acute skeletal muscle loss in critically ill patients.MethodsThis prospective observational cohort study was conducted with patients who were expected to stay in the intensive care unit (ICU) for at least a week. Rectus femoris cross‐sectional area (RFCSA) measurements were performed within 48 h of ICU admission and on study day 7. The percentage change in RFCSA and variables associated with this change were evaluated by univariate and multivariate regression analysis.ResultsOver a 12‐month period, 518 patients were assessed for eligibility and 44 critically ill patients with a mean age of 59.3 ± 10.9 years were enrolled; 52.3% of them were female. There were significant reductions in RFCSA (16.8 ± 16.5%; P < 0.001). The mean amounts of protein and energy consumed compared with those prescribed were 67.0 ± 28.8% and 71.5 ± 38.3%, respectively. Multivariate regression analysis revealed that frailty was independently associated with acute skeletal muscle loss after adjusting for confounding factors in our cohort of patients.ConclusionFrailty status before ICU admission is associated with acute skeletal muscle loss and may be important for identifying critically ill patients at high risk of muscle wasting.

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Transitions in frailty state 12 months after kidney transplantation: a prospective cohort study

Mantovani

Carvalho²,

Minicucci³

et al. 2022

J Nephrol

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Current perspectives on defining and mitigating frailty in relation to critical illness

Cited by 4 publications

References 88 publications

Association between skeletal muscle changes, anthropometric measurements, and clinical outcomes in critically ill trauma and surgical patients: A prospective observational study

Association between skeletal muscle changes, anthropometric measurements, and clinical outcomes in critically ill trauma and surgical patients: A prospective observational study

Nutrition determinants of acute skeletal muscle loss in critically ill patients: A prospective observational cohort study

Transitions in frailty state 12 months after kidney transplantation: a prospective cohort study

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