Relationship between the Clinical Frailty Scale and short-term mortality in patients > or = 80 years old acutely admitted to the ICU : a prospective cohort study

2021
journal article
article
34
dc.abstract.enBackground: The Clinical Frailty Scale (CFS) is frequently used to measure frailty in critically ill adults. There is wide variation in the approach to analysing the relationship between the CFS score and mortality after admission to the ICU. This study aimed to evaluate the influence of modelling approach on the association between the CFS score and short-term mortality and quantify the prognostic value of frailty in this context. Methods: We analysed data from two multicentre prospective cohort studies which enrolled intensive care unit patients ≥ 80 years old in 26 countries. The primary outcome was mortality within 30-days from admission to the ICU. Logistic regression models for both ICU and 30-day mortality included the CFS score as either a categorical, continuous or dichotomous variable and were adjusted for patient’s age, sex, reason for admission to the ICU, and admission Sequential Organ Failure Assessment score. Result: The median age in the sample of 7487 consecutive patients was 84 years (IQR 81–87). The highest fraction of new prognostic information from frailty in the context of 30-day mortality was observed when the CFS score was treated as either a categorical variable using all original levels of frailty or a nonlinear continuous variable and was equal to 9% using these modelling approaches (p < 0.001). The relationship between the CFS score and mortality was nonlinear (p < 0.01). Conclusion: Knowledge about a patient’s frailty status adds a substantial amount of new prognostic information at the moment of admission to the ICU. Arbitrary simplification of the CFS score into fewer groups than originally intended leads to a loss of information and should be avoided.
dc.affiliationWydział Lekarski : Zakład Intensywnej Terapii i Medycyny Okołozabiegowejpl
dc.cm.date2021-08-27
dc.cm.id104939
dc.cm.idOmegaUJCM957d95214f654bd19c408f2851847dfdpl
dc.contributor.authorFronczek, Jakub - 207383 pl
dc.contributor.authorPolok, Kamil - 187390 pl
dc.contributor.authorDe Lange, Dylan W.pl
dc.contributor.authorJung, Christianpl
dc.contributor.authorBeil, Michaelpl
dc.contributor.authorRhodes, Andrewpl
dc.contributor.authorFjolner, Jesperpl
dc.contributor.authorGórka, Jacek - 114863 pl
dc.contributor.authorAndersen, Finn H.pl
dc.contributor.authorArtigas, Antoniopl
dc.contributor.authorCecconi, Mauriziopl
dc.contributor.authorChristensen, Steffenpl
dc.contributor.authorJoannidis, Michaelpl
dc.contributor.authorLeaver, Susannahpl
dc.contributor.authorMarsh, Brianpl
dc.contributor.authorMorandi, Alessandropl
dc.contributor.authorMoreno, Ruipl
dc.contributor.authorOeyen, Sandrapl
dc.contributor.authorAgvald-Ohman, Christinapl
dc.contributor.authorPinto, Bernardo Bollenpl
dc.contributor.authorSchefold, Joerg C.pl
dc.contributor.authorValentin, Andreaspl
dc.contributor.authorWalther, Stenpl
dc.contributor.authorWatson, Ximenapl
dc.contributor.authorZafeiridis, Tilemachospl
dc.contributor.authorSviri, Sigalpl
dc.contributor.authorvan Heerden, Peter Vernonpl
dc.contributor.authorFlaatten, Hanspl
dc.contributor.authorGuidet, Bertrandpl
dc.contributor.authorSzczeklik, Wojciech - 133561 pl
dc.date.accession2022-02-01pl
dc.date.accessioned2021-08-27T10:31:26Z
dc.date.available2021-08-27T10:31:26Z
dc.date.issued2021pl
dc.date.openaccess0
dc.description.accesstimew momencie opublikowania
dc.description.number1pl
dc.description.points140
dc.description.versionostateczna wersja wydawcy
dc.description.volume25pl
dc.identifier.articleid231pl
dc.identifier.doi10.1186/s13054-021-03632-3pl
dc.identifier.eissn1466-609Xpl
dc.identifier.issn1364-8535pl
dc.identifier.projectROD UJ / Opl
dc.identifier.urihttps://ruj.uj.edu.pl/xmlui/handle/item/277757
dc.identifier.weblinkhttps://ccforum.biomedcentral.com/articles/10.1186/s13054-021-03632-3pl
dc.languageengpl
dc.language.containerengpl
dc.pbn.affiliationDziedzina nauk medycznych i nauk o zdrowiu : nauki medyczne
dc.relation.uri*
dc.rightsUdzielam licencji. Uznanie autorstwa 4.0 Międzynarodowa
dc.rights.licenceCC-BY
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/legalcode.pl
dc.share.typeOtwarte czasopismo
dc.subject.enintensive care units
dc.subject.enaged
dc.subject.en80 and over
dc.subject.enfrailty
dc.subject.enprospective studies
dc.subject.enmortality
dc.subtypeArticlepl
dc.titleRelationship between the Clinical Frailty Scale and short-term mortality in patients > or = 80 years old acutely admitted to the ICU : a prospective cohort studypl
dc.title.journalCritical Carepl
dc.typeJournalArticlepl
dspace.entity.typePublication
dc.abstract.en
Background: The Clinical Frailty Scale (CFS) is frequently used to measure frailty in critically ill adults. There is wide variation in the approach to analysing the relationship between the CFS score and mortality after admission to the ICU. This study aimed to evaluate the influence of modelling approach on the association between the CFS score and short-term mortality and quantify the prognostic value of frailty in this context. Methods: We analysed data from two multicentre prospective cohort studies which enrolled intensive care unit patients ≥ 80 years old in 26 countries. The primary outcome was mortality within 30-days from admission to the ICU. Logistic regression models for both ICU and 30-day mortality included the CFS score as either a categorical, continuous or dichotomous variable and were adjusted for patient’s age, sex, reason for admission to the ICU, and admission Sequential Organ Failure Assessment score. Result: The median age in the sample of 7487 consecutive patients was 84 years (IQR 81–87). The highest fraction of new prognostic information from frailty in the context of 30-day mortality was observed when the CFS score was treated as either a categorical variable using all original levels of frailty or a nonlinear continuous variable and was equal to 9% using these modelling approaches (p < 0.001). The relationship between the CFS score and mortality was nonlinear (p < 0.01). Conclusion: Knowledge about a patient’s frailty status adds a substantial amount of new prognostic information at the moment of admission to the ICU. Arbitrary simplification of the CFS score into fewer groups than originally intended leads to a loss of information and should be avoided.
dc.affiliationpl
Wydział Lekarski : Zakład Intensywnej Terapii i Medycyny Okołozabiegowej
dc.cm.date
2021-08-27
dc.cm.id
104939
dc.cm.idOmegapl
UJCM957d95214f654bd19c408f2851847dfd
dc.contributor.authorpl
Fronczek, Jakub - 207383
dc.contributor.authorpl
Polok, Kamil - 187390
dc.contributor.authorpl
De Lange, Dylan W.
dc.contributor.authorpl
Jung, Christian
dc.contributor.authorpl
Beil, Michael
dc.contributor.authorpl
Rhodes, Andrew
dc.contributor.authorpl
Fjolner, Jesper
dc.contributor.authorpl
Górka, Jacek - 114863
dc.contributor.authorpl
Andersen, Finn H.
dc.contributor.authorpl
Artigas, Antonio
dc.contributor.authorpl
Cecconi, Maurizio
dc.contributor.authorpl
Christensen, Steffen
dc.contributor.authorpl
Joannidis, Michael
dc.contributor.authorpl
Leaver, Susannah
dc.contributor.authorpl
Marsh, Brian
dc.contributor.authorpl
Morandi, Alessandro
dc.contributor.authorpl
Moreno, Rui
dc.contributor.authorpl
Oeyen, Sandra
dc.contributor.authorpl
Agvald-Ohman, Christina
dc.contributor.authorpl
Pinto, Bernardo Bollen
dc.contributor.authorpl
Schefold, Joerg C.
dc.contributor.authorpl
Valentin, Andreas
dc.contributor.authorpl
Walther, Sten
dc.contributor.authorpl
Watson, Ximena
dc.contributor.authorpl
Zafeiridis, Tilemachos
dc.contributor.authorpl
Sviri, Sigal
dc.contributor.authorpl
van Heerden, Peter Vernon
dc.contributor.authorpl
Flaatten, Hans
dc.contributor.authorpl
Guidet, Bertrand
dc.contributor.authorpl
Szczeklik, Wojciech - 133561
dc.date.accessionpl
2022-02-01
dc.date.accessioned
2021-08-27T10:31:26Z
dc.date.available
2021-08-27T10:31:26Z
dc.date.issuedpl
2021
dc.date.openaccess
0
dc.description.accesstime
w momencie opublikowania
dc.description.numberpl
1
dc.description.points
140
dc.description.version
ostateczna wersja wydawcy
dc.description.volumepl
25
dc.identifier.articleidpl
231
dc.identifier.doipl
10.1186/s13054-021-03632-3
dc.identifier.eissnpl
1466-609X
dc.identifier.issnpl
1364-8535
dc.identifier.projectpl
ROD UJ / O
dc.identifier.uri
https://ruj.uj.edu.pl/xmlui/handle/item/277757
dc.identifier.weblinkpl
https://ccforum.biomedcentral.com/articles/10.1186/s13054-021-03632-3
dc.languagepl
eng
dc.language.containerpl
eng
dc.pbn.affiliation
Dziedzina nauk medycznych i nauk o zdrowiu : nauki medyczne
dc.relation.uri*
dc.rights
Udzielam licencji. Uznanie autorstwa 4.0 Międzynarodowa
dc.rights.licence
CC-BY
dc.rights.uri
http://creativecommons.org/licenses/by/4.0/legalcode.pl
dc.share.type
Otwarte czasopismo
dc.subject.en
intensive care units
dc.subject.en
aged
dc.subject.en
80 and over
dc.subject.en
frailty
dc.subject.en
prospective studies
dc.subject.en
mortality
dc.subtypepl
Article
dc.titlepl
Relationship between the Clinical Frailty Scale and short-term mortality in patients > or = 80 years old acutely admitted to the ICU : a prospective cohort study
dc.title.journalpl
Critical Care
dc.typepl
JournalArticle
dspace.entity.type
Publication
Affiliations

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