About: The contribution of frailty, cognition, activity of daily life and comorbidities on outcome in acutely admitted patients over 80 years in European ICUs: the VIP2 study

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About: The contribution of frailty, cognition, activity of daily life and comorbidities on outcome in acutely admitted patients over 80 years in European ICUs: the VIP2 study Goto Sponge NotDistinct Permalink

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
title	The contribution of frailty, cognition, activity of daily life and comorbidities on outcome in acutely admitted patients over 80 years in European ICUs: the VIP2 study
Creator	Artigas, Antonio Cecconi, Maurizio Joannidis, Michael Moreno, Rui Jung, Christian Andersen, Finn Boulanger, Carol Boumendil, Ariane De Lange, Dylan Elhadi, Muhammed Fjølner, Jesper Flaatten, Hans Guidet, Bertrand Leaver, Susannah Marsh, Brian Morandi, Alessandro Nalapko, Yuriy Oeyen, Sandra Schefold, Joerg Szczeklik, Wojciech Walther, Sten Watson, Ximena Zafeiridis, Tilemachos
source	PMC
abstract	PURPOSE: Premorbid conditions affect prognosis of acutely-ill aged patients. Several lines of evidence suggest geriatric syndromes need to be assessed but little is known on their relative effect on the 30-day survival after ICU admission. The primary aim of this study was to describe the prevalence of frailty, cognition decline and activity of daily life in addition to the presence of comorbidity and polypharmacy and to assess their influence on 30-day survival. METHODS: Prospective cohort study with 242 ICUs from 22 countries. Patients 80 years or above acutely admitted over a six months period to an ICU between May 2018 and May 2019 were included. In addition to common patients’ characteristics and disease severity, we collected information on specific geriatric syndromes as potential predictive factors for 30-day survival, frailty (Clinical Frailty scale) with a CFS > 4 defining frail patients, cognitive impairment (informant questionnaire on cognitive decline in the elderly (IQCODE) with IQCODE ≥ 3.5 defining cognitive decline, and disability (measured the activity of daily life with the Katz index) with ADL ≤ 4 defining disability. A Principal Component Analysis to identify co-linearity between geriatric syndromes was performed and from this a multivariable model was built with all geriatric information or only one: CFS, IQCODE or ADL. Akaike’s information criterion across imputations was used to evaluate the goodness of fit of our models. RESULTS: We included 3920 patients with a median age of 84 years (IQR: 81–87), 53.3% males). 80% received at least one organ support. The median ICU length of stay was 3.88 days (IQR: 1.83–8). The ICU and 30-day survival were 72.5% and 61.2% respectively. The geriatric conditions were median (IQR): CFS: 4 (3–6); IQCODE: 3.19 (3–3.69); ADL: 6 (4–6); Comorbidity and Polypharmacy score (CPS): 10 (7–14). CFS, ADL and IQCODE were closely correlated. The multivariable analysis identified predictors of 1-month mortality (HR; 95% CI): Age (per 1 year increase): 1.02 (1.–1.03, p = 0.01), ICU admission diagnosis, sequential organ failure assessment score (SOFA) (per point): 1.15 (1.14–1.17, p < 0.0001) and CFS (per point): 1.1 (1.05–1.15, p < 0.001). CFS remained an independent factor after inclusion of life-sustaining treatment limitation in the model. CONCLUSION: We confirm that frailty assessment using the CFS is able to predict short-term mortality in elderly patients admitted to ICU. Other geriatric syndromes do not add improvement to the prediction model. Since CFS is easy to measure, it should be routinely collected for all elderly ICU patients in particular in connection to advance care plans, and should be used in decision making. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00134-019-05853-1) contains supplementary material, which is available to authorized users.
has issue date	2019-11-29(xsd:dateTime)
bibo:doi	10.1007/s00134-019-05853-1
bibo:pmid	31784798
has license	no-cc
sha1sum (hex)	d7cb5d0afb377ab15e2ec792c960fbce72cb4d7b
schema:url	https://doi.org/10.1007/s00134-019-05853-1
resource representing a document's title	The contribution of frailty, cognition, activity of daily life and comorbidities on outcome in acutely admitted patients over 80 years in European ICUs: the VIP2 study
has PubMed Central identifier	PMC7223711
has PubMed identifier	31784798
schema:publication	Intensive Care Med
resource representing a document's body	covid:d7cb5d0afb377ab15e2ec792c960fbce72cb4d7b#body_text
is schema:about of	named entity 'survival' named entity 'ICUs' named entity 'activity' named entity 'LIFE' named entity 'ASSESS' named entity 'ICU' named entity 'sepsis' named entity 'ICU' named entity 'polypharmacy' named entity 'Questionnaire' named entity 'risk of death' named entity 'ICU' named entity 'GDPR' named entity 'ICU' named entity 'elderly patients' named entity '0.80' named entity 'positively correlated' named entity 'inverse probability' named entity 'patient records' named entity '1.08' named entity 'tracheotomy' named entity 'ADL score' named entity 'mortality rates' named entity 'aim' named entity 'LST' named entity 'LST' named entity 'demographic data' named entity 'critical illness' named entity 'comorbidity' named entity 'ICU' named entity 'cardiovascular' named entity 'Europe' named entity 'ICU' named entity 'ICU' named entity 'risk of death' named entity 'ICU' named entity 'Akaike's information criterion' named entity 'geriatric' named entity 'dependent variable' named entity 'prospective study' named entity 'cognitive impairment' named entity 'frailty' named entity 'patients' named entity 'prognosis' named entity 'Premorbid' named entity 'ICU' named entity 'geriatric' named entity '80 years' named entity 'geriatric' named entity 'cognitive dysfunction' named entity 'correlation' named entity 'cognitive impairment' named entity 'inverse probability' named entity 'health-related quality of life' named entity 'terminally ill' named entity 'geriatric' named entity 'Comorbidity' named entity 'multiple imputations' named entity 'disability'

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