The impact of frailty on ICU and 30-day mortality and the level of care in very elderly patients (≥ 80 years)

Abstract

ClinicalTrials.gov (ID: NCT03134807).

Frailty in the age of VIPs (very old intensive care patients)

“…In this context, frailty is also increasingly recognized as a common end-of-life trajectory that is associated with considerable health resource use [6,7]. [8]. The main objective of the VIP study was to evaluate the impact of frailty on ICU and 30-day mortality, along with its association with intensity of ICU support provided.…”

Is this critically ill patient elderly or too old?

“…The main focus of the study was to estimate the incidence and impact of frailty among elderly ICU patients [10]. The concept of clinical frailty describes a state of reduced physical, physiologic and cognitive reserve which is associated in ICU patients with increased risk of mortality and adverse outcomes [11,12].…”

“…Although frailty is more common in older individuals, frailty and aging are not synonymous. Interestingly Flaatten and colleagues showed that frailty (stage ≥ 5) was present in 43% of the very old patients admitted to ICU and independently associated with lower 30-day survival [10].…”

The Baby Boom and later life: is critical care fit for the future?

“…Moreover, the subsequently published VIP-1 study, including a contemporary cohort of over 5,000 patients over the age of 80 years from 311 ICUs in 21 European countries confirmed that the increasing scores on the Clinical Frailty Scale assessments were independently associated with increased ICU and 30-day mortality, regardless of the elective or emergency nature of the ICU admission [26]. Although the simple Clinical Frailty Scale appears to be a useful adjunct when deciding about ICU admission, the wider psychometric properties of frailty assessment in the critically ill have been under-explored, while the ideal method of assessing frailty in this population is still unclear [27].…”