Frailty’s influence on 30-day mortality in old critically ill ICU patients

Detalhes bibliográficos
Autor(a) principal: Wernly, Bernhard
Data de Publicação: 2023
Outros Autores: Bruno, Raphael Romano, Beil, Michael, Flaatten, Hans, Kelm, Malte, Sigal, Sviri, Szczeklik, Wojciech, Elhadi, Muhammed, Joannidis, Michael, Koköfer, Andreas, Oeyen, Sandra, Marsh, Brian, Moreno, Rui, Wernly, Sarah, Leaver, Susannah, De Lange, Dylan W., Guidet, Bertrand, Jung, Christian
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10362/161524
Resumo: Funding Information: We acknowledge all members of the VIP community. Publisher Copyright: © 2023, The Author(s).
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spelling Frailty’s influence on 30-day mortality in old critically ill ICU patientsa bayesian analysis evaluating the clinical frailty scaleCritical Care and Intensive Care MedicineFunding Information: We acknowledge all members of the VIP community. Publisher Copyright: © 2023, The Author(s).Introduction: Frailty is widely acknowledged as influencing health outcomes among critically ill old patients. Yet, the traditional understanding of its impact has predominantly been through frequentist statistics. We endeavored to explore this association using Bayesian statistics aiming to provide a more nuanced understanding of this multifaceted relationship. Methods: Our analysis incorporated a cohort of 10,363 older (median age 82 years) patients from three international prospective studies, with 30-day all-cause mortality as the primary outcome. We defined frailty as Clinical Frailty Scale ≥ 5. A hierarchical Bayesian logistic regression model was employed, adjusting for covariables, using a range of priors. An international steering committee of registry members reached a consensus on a minimal clinically important difference (MCID). Results: In our study, the 30-day mortality was 43%, with rates of 38% in non-frail and 51% in frail groups. Post-adjustment, the median odds ratio (OR) for frailty was 1.60 (95% CI 1.45–1.76). Frailty was invariably linked to adverse outcomes (OR > 1) with 100% probability and had a 90% chance of exceeding the minimal clinically important difference (MCID) (OR > 1.5). For the Clinical Frailty Scale (CFS) as a continuous variable, the median OR was 1.19 (1.16–1.22), with over 99% probability of the effect being more significant than 1.5 times the MCID. Frailty remained outside the region of practical equivalence (ROPE) in all analyses, underscoring its clinical importance regardless of how it is measured. Conclusions: This research demonstrates the significant impact of frailty on short-term mortality in critically ill elderly patients, particularly when the Clinical Frailty Scale (CFS) is used as a continuous measure. This approach, which views frailty as a spectrum, enables more effective, personalized care for this vulnerable group. Significantly, frailty was consistently outside the region of practical equivalence (ROPE) in our analysis, highlighting its clinical importance.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)RUNWernly, BernhardBruno, Raphael RomanoBeil, MichaelFlaatten, HansKelm, MalteSigal, SviriSzczeklik, WojciechElhadi, MuhammedJoannidis, MichaelKoköfer, AndreasOeyen, SandraMarsh, BrianMoreno, RuiWernly, SarahLeaver, SusannahDe Lange, Dylan W.Guidet, BertrandJung, Christian2023-12-20T23:55:28Z2023-122023-12-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10362/161524eng2110-5820PURE: 78719328https://doi.org/10.1186/s13613-023-01223-9info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T05:44:27Zoai:run.unl.pt:10362/161524Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:58:34.198683Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Frailty’s influence on 30-day mortality in old critically ill ICU patients
a bayesian analysis evaluating the clinical frailty scale
title Frailty’s influence on 30-day mortality in old critically ill ICU patients
spellingShingle Frailty’s influence on 30-day mortality in old critically ill ICU patients
Wernly, Bernhard
Critical Care and Intensive Care Medicine
title_short Frailty’s influence on 30-day mortality in old critically ill ICU patients
title_full Frailty’s influence on 30-day mortality in old critically ill ICU patients
title_fullStr Frailty’s influence on 30-day mortality in old critically ill ICU patients
title_full_unstemmed Frailty’s influence on 30-day mortality in old critically ill ICU patients
title_sort Frailty’s influence on 30-day mortality in old critically ill ICU patients
author Wernly, Bernhard
author_facet Wernly, Bernhard
Bruno, Raphael Romano
Beil, Michael
Flaatten, Hans
Kelm, Malte
Sigal, Sviri
Szczeklik, Wojciech
Elhadi, Muhammed
Joannidis, Michael
Koköfer, Andreas
Oeyen, Sandra
Marsh, Brian
Moreno, Rui
Wernly, Sarah
Leaver, Susannah
De Lange, Dylan W.
Guidet, Bertrand
Jung, Christian
author_role author
author2 Bruno, Raphael Romano
Beil, Michael
Flaatten, Hans
Kelm, Malte
Sigal, Sviri
Szczeklik, Wojciech
Elhadi, Muhammed
Joannidis, Michael
Koköfer, Andreas
Oeyen, Sandra
Marsh, Brian
Moreno, Rui
Wernly, Sarah
Leaver, Susannah
De Lange, Dylan W.
Guidet, Bertrand
Jung, Christian
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
RUN
dc.contributor.author.fl_str_mv Wernly, Bernhard
Bruno, Raphael Romano
Beil, Michael
Flaatten, Hans
Kelm, Malte
Sigal, Sviri
Szczeklik, Wojciech
Elhadi, Muhammed
Joannidis, Michael
Koköfer, Andreas
Oeyen, Sandra
Marsh, Brian
Moreno, Rui
Wernly, Sarah
Leaver, Susannah
De Lange, Dylan W.
Guidet, Bertrand
Jung, Christian
dc.subject.por.fl_str_mv Critical Care and Intensive Care Medicine
topic Critical Care and Intensive Care Medicine
description Funding Information: We acknowledge all members of the VIP community. Publisher Copyright: © 2023, The Author(s).
publishDate 2023
dc.date.none.fl_str_mv 2023-12-20T23:55:28Z
2023-12
2023-12-01T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10362/161524
url http://hdl.handle.net/10362/161524
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 2110-5820
PURE: 78719328
https://doi.org/10.1186/s13613-023-01223-9
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
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