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Longitudinal outcomes in octogenarian critically ill patients with a focus on frailty and cardiac surgery
Zitieren Sie bitte immer diese 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.…
Autor(en): | 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 |
Dokumentart: | Artikel / Aufsatz in einer Zeitschrift |
Institute der Universität: | Medizinische Fakultät / Klinik und Poliklinik für Anästhesiologie (ab 2004) |
Sprache der Veröffentlichung: | Englisch |
Titel des übergeordneten Werkes / der Zeitschrift (Englisch): | Journal of Clinical Medicine |
ISSN: | 2077-0383 |
Erscheinungsjahr: | 2020 |
Band / Jahrgang: | 10 |
Heft / Ausgabe: | 1 |
Aufsatznummer: | 12 |
Originalveröffentlichung / Quelle: | Journal of Clinical Medicine (2021) 10:1, 12. https://doi.org/10.3390/jcm10010012 |
DOI: | https://doi.org/10.3390/jcm10010012 |
Allgemeine fachliche Zuordnung (DDC-Klassifikation): | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
Freie Schlagwort(e): | aged 80 and over; cardiac surgery; critical care; critical illness; demography; frailty; nutrition therapy; population characteristics; prospective studies |
Datum der Freischaltung: | 14.07.2022 |
Datum der Erstveröffentlichung: | 23.12.2020 |
Lizenz (Deutsch): | CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International |