The impact of frailty on noninvasive mechanical ventilation in elderly medical intensive care unit patients

Kara, İskender; Yıldırım, Funda; Zerman, Avşar; Güllü, Zuhal; Boyacı, Nazlıhan; Aydogan, Burcu Basarik; Gaygısız, Ümmügülsüm; Gonderen, Kamil; Arık, Güneş; Türkoğlu, Melda; Aydoğdu, Müge; Aygencel, Gülbin; Ülger, Zekeriya; Gürsel, Gül

doi:10.1007/s40520-017-0774-z

Cited by 14 publications

(8 citation statements)

References 21 publications

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“…Most common system involved was hepatobiliary system and liver cirrhosis was most commonly diagnosed disease in that category. Other studies reported sepsis as most common diagnosis in ICU related death, [29,39] which was second common diagnosis in our study. Increased incidence of cirrhosis in our study might be due to the fact that alcoholism was more in patients of our study.…”

Section: Discussionsupporting

confidence: 67%

Study of Factors Affecting Deaths in Medicine Ward Patients Including MICU at a Teaching and Tertiary Care Hospital Located in Central India during Period 2013 to 2016

Pande¹

2018

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Section: Discussionsupporting

confidence: 67%

Study of Factors Affecting Deaths in Medicine Ward Patients Including MICU at a Teaching and Tertiary Care Hospital Located in Central India during Period 2013 to 2016

Pande¹

2018

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“…Older patients are more likely frail, which is a multifaceted condition characterized by the loss of physiologic and cognitive reserves ( 3 , 4 ). The observational studies suggest that the patients with frailty currently account for up to one-third of the critically ill ( 5 , 6 ). Consequently, the patient outcome is determined not only by the acute critical illness but increasingly by the reduced functional reserve of pre-existing frailty resulting in higher 30-day mortality ( 5 , 7 , 8 ).…”

Section: Introductionmentioning

confidence: 99%

The Functional Trajectory in Frail Compared With Non-frail Critically Ill Patients During the Hospital Stay

et al. 2021

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Background: Long-term outcome is determined not only by the acute critical illness but increasingly by the reduced functional reserve of pre-existing frailty. The patients with frailty currently account for one-third of the critically ill, resulting in higher mortality. There is evidence of how frailty affects the intrahospital functional trajectory of critically ill patients since prehospital status is often missing.Methods: In this prospective single-center cohort study at two interdisciplinary intensive care units (ICUs) at a university hospital in Germany, the frailty was assessed using the Clinical Frailty Scale (CFS) in the adult patients with critical illness with an ICU stay >24 h. The functional status was assessed using the sum of the subdomains “Mobility” and “Transfer” of the Barthel Index (MTB) at three time points (pre-hospital, ICU discharge, and hospital discharge).Results: We included 1,172 patients with a median age of 75 years, of which 290 patients (25%) were frail. In a propensity score-matched cohort, the probability of MTB deterioration till hospital discharge did not differ in the patients with frailty (odds ratio (OR) 1.3 [95% CI 0.8–1.9], p = 0.301), confirmed in several sensitivity analyses in all the patients and survivors only.Conclusion: The patients with frailty have a reduced functional status. Their intrahospital functional trajectory, however, was not worse than those in non-frail patients, suggesting a rehabilitation potential of function in critically ill patients with frailty.

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The impact of frailty on noninvasive mechanical ventilation in elderly medical intensive care unit patients

2017

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We identified no significant differences in NIV success when age and specific comorbidities were considered [5]. But since patient inclusion criteria of our study were not designed to investigate the answers of these questions we cannot interpret our results as these factors do not have any impact on NIV success. We can just say that both groups have similar percentages of patients with COPD and HF and there was no significant difference in their ages.On the other hand and more importantly with our results, we wanted to draw attention to potential and less investigated causes of NIV failure such as Edmonton Frailty Scale (EFS) criteria (cognition, general health status, functional independence, social support, medications, nutrition, mood, and functional performance). Interestingly compared to age and comorbidities which are unmodifible factors many of EFS criteria are modifiable. We believe not only age and comorbidities but also these frailty factors should be investigated as causes of NIV failure in future.We totally agree with these recommendations and want to thank them for their contribution. References

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The impact of frailty on noninvasive mechanical ventilation in elderly medical intensive care unit patients

Abstract: The frailty is associated with higher NIV application problems, failure and mortality risk in elderly ICU patients. The CFS and EFS frailty scores can be used to predict NIV success and outcomes in ICUs.

Cited by 14 publications

References 21 publications

Study of Factors Affecting Deaths in Medicine Ward Patients Including MICU at a Teaching and Tertiary Care Hospital Located in Central India during Period 2013 to 2016

Study of Factors Affecting Deaths in Medicine Ward Patients Including MICU at a Teaching and Tertiary Care Hospital Located in Central India during Period 2013 to 2016

The Functional Trajectory in Frail Compared With Non-frail Critically Ill Patients During the Hospital Stay

The impact of frailty on noninvasive mechanical ventilation in elderly medical intensive care unit patients

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