Association of frailty with short-term outcomes, organ support and resource use in critically ill patients
| Autor(a) principal: | |
|---|---|
| Data de Publicação: | 2018 |
| Outros Autores: | , , , , , , , , , , , , , , , , , , , , |
| Tipo de documento: | Artigo |
| Idioma: | eng |
| Título da fonte: | Repositório Institucional da FIOCRUZ (ARCA) |
| Texto Completo: | https://www.arca.fiocruz.br/handle/icict/33653 |
Resumo: | 2020-06-25 |
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Zampieri, Fernando G.Iwashyna, Theodore J.Viglianti, Elizabeth M.Taniguchi, Leandro U.Viana, William N.Costa, RobertoCorrêa, Thiago D.Moreira, Carlos Eduardo N.Maia, Marcelo O.Moralez, Giulliana M.Lisboa, ThiagoFerez, Marcus A.Freitas, Carlos Eduardo F.Carvalho, Clayton B. deMazza, Bruno F.Lima, Mariza F. A.Ramos, Grazielle V.Silva, Aline R.Bozza, Fernando A.Salluh, Jorge I. F.Soares, MarcioORCHESTRA Study Investigators2019-06-25T13:22:41Z2019-06-25T13:22:41Z2018ZAMPIERI, Fernando G. et al. Association of frailty with short-term outcomes, organ support and resource use in critically ill patients. Intensive Care Medicine, v. 44, p. 1512-1520, 2018.0342-4642https://www.arca.fiocruz.br/handle/icict/3365310.1007/s00134-018-5342-21432-1238engSpringerAssociation of frailty with short-term outcomes, organ support and resource use in critically ill patientsinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article2020-06-25Hospital do Coração. Research Institute. São Paulo, SP, Brazil / Hospital Alemão Oswaldo Cruz. Intensive Care Unit. São Paulo, SP, Brazil.University of Michigan. Department of Internal Medicine. Ann Arbor, MI, USA / HSR&D Center for Excellence. Veterans Afairs Center for Clinical Management Research. Ann Arbor, MI, USA.University of Michigan. Department of Internal Medicine. Ann Arbor, MI, USA.Hospital Sírio Libanês. Intensive Care Unit. São Paulo, SP, Brazil / Universidade de São Paulo. Hospital das Clínicas. Emergency Medicine Discipline. São Paulo, SP, Brazil.Hospital Copa D’Or. Intensive Care Unit. Rio de Janeiro, RJ, Brazil.Hospital Quinta D’Or. Intensive Care Unit. Rio de Janeiro, RJ, Brazil.Hospital Israelita Albert Einstein. Adult Intensive Care Unit. São Paulo, SP, Brazil.Hospital Nove de Julho. Intensive Care Unit. São Paulo, SP, Brazil.Rede D’Or São Luiz. Hospital Santa Luzia. Intensive Care Unit. Brasília, DF, Brazil.D’Or Institute for Research and Education. Graduate Program in Translational Medicine. Department of Critical Care. Rio De Janeiro, RJ, Brazil.Santa Casa de Misericórdia de Porto Alegre. Hospital Santa Rita. Intensive Care Unit. Porto Alegre, RS, Brazil.Hospital São Francisco. Intensive Care Unit. Ribeirão Preto, SP, Brazil.Hospital Esperança Olinda. Intensive Care Unit. Olinda, PE, Brazil.Hospital Brasília. Intensive Care Unit. Brasília, DF, Brazil.Hospital Samaritano. Intensive Care Unit. São Paulo, SP, Brazil.Hospital Esperança. Intensive Care Unit. Recife, PE, Brazil.D’Or Institute for Research and Education. Graduate Program in Translational Medicine. Department of Critical Care. Rio De Janeiro, RJ, Brazil.D’Or Institute for Research and Education. Graduate Program in Translational Medicine. Department of Critical Care. Rio De Janeiro, RJ, Brazil.D’Or Institute for Research and Education. Graduate Program in Translational Medicine. Department of Critical Care. Rio De Janeiro, RJ, Brazil / Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.D’Or Institute for Research and Education. Graduate Program in Translational Medicine. Department of Critical Care. Rio De Janeiro, RJ, Brazil.D’Or Institute for Research and Education. Graduate Program in Translational Medicine. Department of Critical Care. Rio De Janeiro, RJ, Brazil.Purpose: Frail patients are known to experience poor outcomes. Nevertheless, we know less about how frailty manifests itself in patients’ physiology during critical illness and how it afects resource use in intensive care units (ICU). We aimed to assess the association of frailty with short-term outcomes and organ support used by critically ill patients. Methods: Retrospective analysis of prospective collected data from 93 ICUs in Brazil from 2014 to 2015. We assessed frailty using the modifed frailty index (MFI). The primary outcome was in-hospital mortality. Secondary outcomes were discharge home without need for nursing care, ICU and hospital length of stay (LOS), and utilization of ICU organ support and transfusion. We used mixed logistic regression and competing risk models accounting for relevant confounders in outcome analyses. Results: The analysis consisted of 129,680 eligible patients. There were 40,779 (31.4%) non-frail (MFI=0), 64,407 (49.7%) pre-frail (MFI=1–2) and 24,494 (18.9%) frail (MFI≥3) patients. After adjusted analysis, frailty was associated with higher in-hospital mortality (OR 2.42, 95% CI 1.89–3.08), particularly in patients admitted with lower SOFA scores. Frail patients were less likely to be discharged home (OR 0.36, 95% CI 0.54–0.79) and had higher hospital and ICU LOS than non-frail patients. Use of all forms of organ support (mechanical ventilation, non-invasive ventilation, vasopressors, dialysis and transfusions) were more common in frail patients and increased as MFI increased. Conclusions: Frailty, as assessed by MFI, was associated with several patient-centered endpoints including not only survival, but also ICU LOS and organ support.FrailtyModifed frailty indexOrgan supportResource useOutcomesCritical careinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-83104https://www.arca.fiocruz.br/bitstream/icict/33653/1/license.txt79178e5f2a0eb066867a274556814938MD51ORIGINALve_Zampieri_Fernando_etal_INI_2018.pdfve_Zampieri_Fernando_etal_INI_2018.pdfapplication/pdf993121https://www.arca.fiocruz.br/bitstream/icict/33653/2/ve_Zampieri_Fernando_etal_INI_2018.pdfe55e239a5c00a42baa42b28f49ddb90eMD52TEXTve_Zampieri_Fernando_etal_INI_2018.pdf.txtve_Zampieri_Fernando_etal_INI_2018.pdf.txtExtracted 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| dc.title.pt_BR.fl_str_mv |
Association of frailty with short-term outcomes, organ support and resource use in critically ill patients |
| title |
Association of frailty with short-term outcomes, organ support and resource use in critically ill patients |
| spellingShingle |
Association of frailty with short-term outcomes, organ support and resource use in critically ill patients Zampieri, Fernando G. Frailty Modifed frailty index Organ support Resource use Outcomes Critical care |
| title_short |
Association of frailty with short-term outcomes, organ support and resource use in critically ill patients |
| title_full |
Association of frailty with short-term outcomes, organ support and resource use in critically ill patients |
| title_fullStr |
Association of frailty with short-term outcomes, organ support and resource use in critically ill patients |
| title_full_unstemmed |
Association of frailty with short-term outcomes, organ support and resource use in critically ill patients |
| title_sort |
Association of frailty with short-term outcomes, organ support and resource use in critically ill patients |
| author |
Zampieri, Fernando G. |
| author_facet |
Zampieri, Fernando G. Iwashyna, Theodore J. Viglianti, Elizabeth M. Taniguchi, Leandro U. Viana, William N. Costa, Roberto Corrêa, Thiago D. Moreira, Carlos Eduardo N. Maia, Marcelo O. Moralez, Giulliana M. Lisboa, Thiago Ferez, Marcus A. Freitas, Carlos Eduardo F. Carvalho, Clayton B. de Mazza, Bruno F. Lima, Mariza F. A. Ramos, Grazielle V. Silva, Aline R. Bozza, Fernando A. Salluh, Jorge I. F. Soares, Marcio ORCHESTRA Study Investigators |
| author_role |
author |
| author2 |
Iwashyna, Theodore J. Viglianti, Elizabeth M. Taniguchi, Leandro U. Viana, William N. Costa, Roberto Corrêa, Thiago D. Moreira, Carlos Eduardo N. Maia, Marcelo O. Moralez, Giulliana M. Lisboa, Thiago Ferez, Marcus A. Freitas, Carlos Eduardo F. Carvalho, Clayton B. de Mazza, Bruno F. Lima, Mariza F. A. Ramos, Grazielle V. Silva, Aline R. Bozza, Fernando A. Salluh, Jorge I. F. Soares, Marcio ORCHESTRA Study Investigators |
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author author author author author author author author author author author author author author author author author author author author author |
| dc.contributor.author.fl_str_mv |
Zampieri, Fernando G. Iwashyna, Theodore J. Viglianti, Elizabeth M. Taniguchi, Leandro U. Viana, William N. Costa, Roberto Corrêa, Thiago D. Moreira, Carlos Eduardo N. Maia, Marcelo O. Moralez, Giulliana M. Lisboa, Thiago Ferez, Marcus A. Freitas, Carlos Eduardo F. Carvalho, Clayton B. de Mazza, Bruno F. Lima, Mariza F. A. Ramos, Grazielle V. Silva, Aline R. Bozza, Fernando A. Salluh, Jorge I. F. Soares, Marcio ORCHESTRA Study Investigators |
| dc.subject.en.pt_BR.fl_str_mv |
Frailty Modifed frailty index Organ support Resource use Outcomes Critical care |
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Frailty Modifed frailty index Organ support Resource use Outcomes Critical care |
| description |
2020-06-25 |
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2018 |
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2018 |
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2019-06-25T13:22:41Z |
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2019-06-25T13:22:41Z |
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info:eu-repo/semantics/publishedVersion |
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ZAMPIERI, Fernando G. et al. Association of frailty with short-term outcomes, organ support and resource use in critically ill patients. Intensive Care Medicine, v. 44, p. 1512-1520, 2018. |
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https://www.arca.fiocruz.br/handle/icict/33653 |
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0342-4642 |
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10.1007/s00134-018-5342-2 |
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1432-1238 |
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ZAMPIERI, Fernando G. et al. Association of frailty with short-term outcomes, organ support and resource use in critically ill patients. Intensive Care Medicine, v. 44, p. 1512-1520, 2018. 0342-4642 10.1007/s00134-018-5342-2 1432-1238 |
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Springer |
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Springer |
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