The association of premorbid conditions with 6-month mortality in acutely admitted ICU patients over 80 years
Abstract Background Premorbid conditions influence the outcome of acutely ill adult patients aged 80 years and over who are admitted to the ICU. The aim of this study was to determine the influence of such premorbid conditions on 6 month survival. Methods Prospective cohort study in 242 ICUs from 22...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2024-03-01
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| Series: | Annals of Intensive Care |
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| Online Access: | https://doi.org/10.1186/s13613-024-01246-w |
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| author | Dylan W. de Lange Ivo W. Soliman Susannah Leaver Ariane Boumendil Lenneke E. M. Haas Ximena Watson Carol Boulanger Wojciech Szczeklik Antonio Artigas Alessandro Morandi Finn Andersen Christian Jung Rui Moreno Sten Walther Sandra Oeyen Joerg C. Schefold Maurizio Cecconi Brian Marsh Michael Joannidis Yuriy Nalapko Muhammed Elhadi Jesper Fjølner Bertrand Guidet Hans Flaatten the VIP2 study group |
| author_facet | Dylan W. de Lange Ivo W. Soliman Susannah Leaver Ariane Boumendil Lenneke E. M. Haas Ximena Watson Carol Boulanger Wojciech Szczeklik Antonio Artigas Alessandro Morandi Finn Andersen Christian Jung Rui Moreno Sten Walther Sandra Oeyen Joerg C. Schefold Maurizio Cecconi Brian Marsh Michael Joannidis Yuriy Nalapko Muhammed Elhadi Jesper Fjølner Bertrand Guidet Hans Flaatten the VIP2 study group |
| author_sort | Dylan W. de Lange |
| collection | DOAJ |
| description | Abstract Background Premorbid conditions influence the outcome of acutely ill adult patients aged 80 years and over who are admitted to the ICU. The aim of this study was to determine the influence of such premorbid conditions on 6 month survival. Methods Prospective cohort study in 242 ICUs from 22 countries including patients 80 years or above, admitted over a 6 months period to an ICU between May 2018 and May 2019. Only emergency (acute) ICU admissions in adult patients ≥ 80 years of age were eligible. Patients who were admitted after planned/elective surgery were excluded. We measured the Clinical Frailty Scale (CFS), the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), disability with the Katz activities of daily living (ADL) score, comorbidities and a Polypharmacy Score (CPS). Results Overall, the VIP2 study included 3920 patients. During ICU stay 1191 patients died (30.9%), and another 436 patients (11.1%) died after ICU discharge but within the first 30 days of admission, and an additional 895 patients died hereafter but within the first 6 months after admission (22.8%). The 6 months mortality was 64%. The median CFS was 4 (IQR 3–6). Frailty (CFS ≥ 5) was present in 26.6%. Cognitive decline (IQCODE above 3.5) was found in 30.2%. The median IQCODE was 3.19. A Katz ADL of 4 or less was present in 27.7%. Patients who surviving > 6 months were slightly younger (median age survivors 84 with IQR 81–86) than patients dying within the first 6 months (median age 84, IQR 82–87, p = 0.013), were less frequently frail (CFS > 5 in 19% versus 34%, p < 0.01) and were less dependent based on their Katz activities of daily living measurement (median Katz score 6, IQR 5–6 versus 6 points, IQR 3–6, p < 0.01). Conclusions We found that Clinical Frailty Scale, age, and SOFA at admission were independent prognostic factors for 6 month mortality after ICU admission in patients age 80 and above. Adding other geriatric syndromes and scores did not improve the model. This information can be used in shared-decision making. ClinicalTrials.gov: NCT03370692. |
| first_indexed | 2024-04-24T16:12:56Z |
| format | Article |
| id | doaj.art-2202724d02fb46a3808a1dc649ea93b5 |
| institution | Directory Open Access Journal |
| issn | 2110-5820 |
| language | English |
| last_indexed | 2024-04-24T16:12:56Z |
| publishDate | 2024-03-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Annals of Intensive Care |
| spelling | doaj.art-2202724d02fb46a3808a1dc649ea93b52024-03-31T11:35:28ZengSpringerOpenAnnals of Intensive Care2110-58202024-03-011411910.1186/s13613-024-01246-wThe association of premorbid conditions with 6-month mortality in acutely admitted ICU patients over 80 yearsDylan W. de Lange0Ivo W. Soliman1Susannah Leaver2Ariane Boumendil3Lenneke E. M. Haas4Ximena Watson5Carol Boulanger6Wojciech Szczeklik7Antonio Artigas8Alessandro Morandi9Finn Andersen10Christian Jung11Rui Moreno12Sten Walther13Sandra Oeyen14Joerg C. Schefold15Maurizio Cecconi16Brian Marsh17Michael Joannidis18Yuriy Nalapko19Muhammed Elhadi20Jesper Fjølner21Bertrand Guidet22Hans Flaatten23the VIP2 study groupDepartment of Intensive Care Medicine, University Medical Center, University UtrechtDepartment of Intensive Care Medicine, University Medical Center, University UtrechtDepartment of critical care, St George’s Hospital LondonAP-HP, Hôpital Saint-AntoineDepartment of Intensive Care, Diakonessen HospitalDepartment of critical care, St George’s Hospital LondonIntensive Care Unit, Royal Devon & Exeter NHS Foundation TrustCenter for Intensive Care and Perioperative Medicine, Jagiellonian University Medical CollegeDepartment of Intensive Care Medecine, CIBER Enfermedades Respiratorias, Corporacion Sanitaria Universitaria Parc Tauli, Autonomous University of BarcelonaDepartment of Rehabilitation Hospital Ancelle di CremonaDepartment of Anaesthesia and Intensive Care, Ålesund HospitalDivision of Cardiology, Pulmonology and Vascular Medicine, University Hospital Düsseldorf, Heinrich-Heine-UniversityFaculdade de Ciências Médicas de Lisboa (Nova Médical School), Hospital de São José, Centro Hospitalar Universitário de Lisboa CentralLinkoping University HospitalDepartment of Intensive Care 1K12IC, Ghent University HospitalDepartment of Intensive Care Medicine, Inselspital, Universitätsspital, University of BernDepartment of Anesthesia and Intensive Care Medicine, Humanitas Clinical and Research Center - IRCCSMater Misericordiae University HospitalDivision of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University InnsbruckEuropean Wellness International, ICUAlkhums Hospital, ICUDepartment of Anaesthesia and Intensive Care, Viborg Regional HospitalSorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, AP-HP, Hôpital Saint-AntoineDepartment of Clinical Medicine, Department of Anaesthesia and Intensive Care, University of Bergen, Haukeland University HospitalAbstract Background Premorbid conditions influence the outcome of acutely ill adult patients aged 80 years and over who are admitted to the ICU. The aim of this study was to determine the influence of such premorbid conditions on 6 month survival. Methods Prospective cohort study in 242 ICUs from 22 countries including patients 80 years or above, admitted over a 6 months period to an ICU between May 2018 and May 2019. Only emergency (acute) ICU admissions in adult patients ≥ 80 years of age were eligible. Patients who were admitted after planned/elective surgery were excluded. We measured the Clinical Frailty Scale (CFS), the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), disability with the Katz activities of daily living (ADL) score, comorbidities and a Polypharmacy Score (CPS). Results Overall, the VIP2 study included 3920 patients. During ICU stay 1191 patients died (30.9%), and another 436 patients (11.1%) died after ICU discharge but within the first 30 days of admission, and an additional 895 patients died hereafter but within the first 6 months after admission (22.8%). The 6 months mortality was 64%. The median CFS was 4 (IQR 3–6). Frailty (CFS ≥ 5) was present in 26.6%. Cognitive decline (IQCODE above 3.5) was found in 30.2%. The median IQCODE was 3.19. A Katz ADL of 4 or less was present in 27.7%. Patients who surviving > 6 months were slightly younger (median age survivors 84 with IQR 81–86) than patients dying within the first 6 months (median age 84, IQR 82–87, p = 0.013), were less frequently frail (CFS > 5 in 19% versus 34%, p < 0.01) and were less dependent based on their Katz activities of daily living measurement (median Katz score 6, IQR 5–6 versus 6 points, IQR 3–6, p < 0.01). Conclusions We found that Clinical Frailty Scale, age, and SOFA at admission were independent prognostic factors for 6 month mortality after ICU admission in patients age 80 and above. Adding other geriatric syndromes and scores did not improve the model. This information can be used in shared-decision making. ClinicalTrials.gov: NCT03370692.https://doi.org/10.1186/s13613-024-01246-wCritical careOutcomeFrailtyCognitive functioningActivities of daily livingComorbidity |
| spellingShingle | Dylan W. de Lange Ivo W. Soliman Susannah Leaver Ariane Boumendil Lenneke E. M. Haas Ximena Watson Carol Boulanger Wojciech Szczeklik Antonio Artigas Alessandro Morandi Finn Andersen Christian Jung Rui Moreno Sten Walther Sandra Oeyen Joerg C. Schefold Maurizio Cecconi Brian Marsh Michael Joannidis Yuriy Nalapko Muhammed Elhadi Jesper Fjølner Bertrand Guidet Hans Flaatten the VIP2 study group The association of premorbid conditions with 6-month mortality in acutely admitted ICU patients over 80 years Annals of Intensive Care Critical care Outcome Frailty Cognitive functioning Activities of daily living Comorbidity |
| title | The association of premorbid conditions with 6-month mortality in acutely admitted ICU patients over 80 years |
| title_full | The association of premorbid conditions with 6-month mortality in acutely admitted ICU patients over 80 years |
| title_fullStr | The association of premorbid conditions with 6-month mortality in acutely admitted ICU patients over 80 years |
| title_full_unstemmed | The association of premorbid conditions with 6-month mortality in acutely admitted ICU patients over 80 years |
| title_short | The association of premorbid conditions with 6-month mortality in acutely admitted ICU patients over 80 years |
| title_sort | association of premorbid conditions with 6 month mortality in acutely admitted icu patients over 80 years |
| topic | Critical care Outcome Frailty Cognitive functioning Activities of daily living Comorbidity |
| url | https://doi.org/10.1186/s13613-024-01246-w |
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