Bibliographic Details
| Title: |
The Clinical Frailty Scale for mortality prediction of old acutely admitted intensive care patients: a meta-analysis of individual patient-level data. |
| Authors: |
Bruno, Raphael Romano, Wernly, Bernhard, Bagshaw, Sean M., van den Boogaard, Mark, Darvall, Jai N., De Geer, Lina, de Gopegui Miguelena, Pablo Ruiz, Heyland, Daren K., Hewitt, David, Hope, Aluko A., Langlais, Emilie, Le Maguet, Pascale, Montgomery, Carmel L., Papageorgiou, Dimitrios, Seguin, Philippe, Geense, Wytske W., Silva-Obregón, J. Alberto, Wolff, Georg, Polzin, Amin, Dannenberg, Lisa |
| Source: |
Annals of Intensive Care; 5/3/2023, Vol. 13 Issue 1, p1-13, 13p |
| Subject Terms: |
INTENSIVE care patients, OLDER patients, FRAILTY, INTENSIVE care units |
| Company/Entity: |
OPEN Software Foundation |
| Abstract: |
Background: This large-scale analysis pools individual data about the Clinical Frailty Scale (CFS) to predict outcome in the intensive care unit (ICU). Methods: A systematic search identified all clinical trials that used the CFS in the ICU (PubMed searched until 24th June 2020). All patients who were electively admitted were excluded. The primary outcome was ICU mortality. Regression models were estimated on the complete data set, and for missing data, multiple imputations were utilised. Cox models were adjusted for age, sex, and illness acuity score (SOFA, SAPS II or APACHE II). Results: 12 studies from 30 countries with anonymised individualised patient data were included (n = 23,989 patients). In the univariate analysis for all patients, being frail (CFS ≥ 5) was associated with an increased risk of ICU mortality, but not after adjustment. In older patients (≥ 65 years) there was an independent association with ICU mortality both in the complete case analysis (HR 1.34 (95% CI 1.25–1.44), p < 0.0001) and in the multiple imputation analysis (HR 1.35 (95% CI 1.26–1.45), p < 0.0001, adjusted for SOFA). In older patients, being vulnerable (CFS 4) alone did not significantly differ from being frail. After adjustment, a CFS of 4–5, 6, and ≥ 7 was associated with a significantly worse outcome compared to CFS of 1–3. Conclusions: Being frail is associated with a significantly increased risk for ICU mortality in older patients, while being vulnerable alone did not significantly differ. New Frailty categories might reflect its "continuum" better and predict ICU outcome more accurately. Trial registration: Open Science Framework (OSF: https://osf.io/8buwk/). [ABSTRACT FROM AUTHOR] |
|
Copyright of Annals of Intensive Care is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| Database: |
Complementary Index |
