Longitudinal outcomes in octogenarian critically ill patients with a focus on frailty and cardiac surgery
Please always quote using this URN: urn:nbn:de:bvb:20-opus-220064
- Cardiac surgery (CSX) can be lifesaving in elderly patients (age ≥ 80 years) but may still be associated with complications and functional decline. Frailty represents a determinant to outcomes in critically ill patients, but little is known about its influence on elderly CSX-patients. This is a secondary exploratory analysis of a multi-center, prospective observational cohort study of 610 elderly patients admitted to the ICU and followed for one year to document long-term outcomes. CSX-ICU-patients (n = 49) were compared to surgical ICUCardiac surgery (CSX) can be lifesaving in elderly patients (age ≥ 80 years) but may still be associated with complications and functional decline. Frailty represents a determinant to outcomes in critically ill patients, but little is known about its influence on elderly CSX-patients. This is a secondary exploratory analysis of a multi-center, prospective observational cohort study of 610 elderly patients admitted to the ICU and followed for one year to document long-term outcomes. CSX-ICU-patients (n = 49) were compared to surgical ICU patients (n = 184) with regard to demographics, frailty, and outcomes. Of all surgical patients, 102 (43%) were considered vulnerable or frail. The subdistribution hazard ratio (SHR) of time to discharge home (TTDH) for vulnerable/frail vs. fit/well patients was 0.54 (95% confidence interval (CI), 0.34, 0.86, p = 0.007). The p-value for effect modification between surgery group (CSX vs. surgical ICU patients) and Clinical Frailty Scale (CFS) group was not significant (p = 0.37) suggesting that the observed difference in the CFS effect between the CSX and surgical ICU patients is consistent with random error. A further subgroup analysis shows that among surgical ICU patients, the SHR of time to discharge home (TTDH) for vulnerable/frail vs. fit/well patients was 0.49 (95% CI, 0.29, 0.83) while the corresponding SHR for CSX patients was 0.77 (0.32–1.88). In conclusion, preoperative frailty reduced the rate of discharge to home in both surgical and CSX patients, but a larger sample of CSX patients is needed to adequately address this question in this patient group.…
Author: | Aileen Hill, Daren K. Heyland, Rolf Rossaint, Rakesh C. Arora, Daniel T. Engelman, Andrew G. Day, Christian Stoppe |
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URN: | urn:nbn:de:bvb:20-opus-220064 |
Document Type: | Journal article |
Faculties: | Medizinische Fakultät / Klinik und Poliklinik für Anästhesiologie (ab 2004) |
Language: | English |
Parent Title (English): | Journal of Clinical Medicine |
ISSN: | 2077-0383 |
Year of Completion: | 2020 |
Volume: | 10 |
Issue: | 1 |
Article Number: | 12 |
Source: | Journal of Clinical Medicine (2021) 10:1, 12. https://doi.org/10.3390/jcm10010012 |
DOI: | https://doi.org/10.3390/jcm10010012 |
Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
Tag: | aged 80 and over; cardiac surgery; critical care; critical illness; demography; frailty; nutrition therapy; population characteristics; prospective studies |
Release Date: | 2022/07/14 |
Date of first Publication: | 2020/12/23 |
Licence (German): | CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International |