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Frailty is associated with long-term outcome in patients with sepsis who are over 80 years old: results from an observational study in 241 European ICUs

Oxford University Press; Volume: 50; Issue: 5 Linguagem: Inglês

10.1093/ageing/afab036

1468-2834

Lenneke Haas, Ariane Boumendil, Hans Flaatten, Bertrand Guidet, Mercedes Ibarz, Christian Jung, Rui P. Moreno, Alessandro Morandi, Finn H. Andersen, Tilemachos Zafeiridis, Sten Walther, Sandra Oeyen, Susannah Leaver, Ximena Watson, Carole Boulanger, Wojciech Szczeklik, Joerg C. Schefold, Maurizio Cecconi, Brian Marsh, Michael Joannidis, Yuriy Nalapko, Muhammed Elhadi, Jesper Fjølner, Antonio Artigas, Dylan W. de Lange, Michael Joannidis, Philipp Eller, Raimund Helbok, René Schmutz, Joke Nollet, Nikolaas De Neve, Pieter De Buysscher, Sandra Oeyen, Walter Swinnen, Marijana Mikačić, Anders Bastiansen, Andreas Husted, Bård E S Dahle, Christine Cramer, Christoffer Sølling, Dorthe Ørsnes, Jakob Edelberg Thomsen, Jonas Juul Pedersen, Mathilde Hummelmose Enevoldsen, Thomas Elkmann, Agnieszka Kubisz-Pudelko, Alan Pope, Amy Collins, Ashok Raj, Carole Boulanger, Christian Frey, Ciaran Hart, Clare Bolger, Dominic W. K. Spray, Georgina Randell, Helder Filipe, Ingeborg Welters, Irina Grecu, Jane C. Evans, Jason Cupitt, Jenny Lord, Jeremy Henning, Joanne L. Jones, Jonathan Ball, Julie North, Kiran Salaunkey, Laura Ortiz-Ruiz de Gordoa, Louise Bell, Madhu Balasubramaniam, Marcela P. Vizcaychipi, Maria Faulkner, McDonald Mupudzi, Megan Lea-Hagerty, Michael Reay, Michael Z. Spivey, Nicholas Love, Nick Spittle Nick Spittle, Nigel White, Patricia Williams, Patrick Morgan, Phillipa Wakefield, Rachel Savine, Reni Jacob, Richard Innes, Ritoo Kapoor, Sally Humphreys, Steve Rose, Susan Dowling, Susannah Leaver, Tarkeshwari Mane, Tom Lawton, Vongayi Ogbeide, Waqas Khaliq, Yolanda Baird, Antoine Romen, Arnaud Galbois, Bertrand Guidet, Christophe Vinsonneau, Cyril Charron, Didier Thévenin, Emmanuel Guérot, Guillaume Besch, Guillaume Savary, Hervé Mentec, Jean-Luc Chagnon, Jean‐Philippe Rigaud, Jean‐Pierre Quenot, Jeremy Castaneray, Jérémy Rosman, Julien Maizel, Kelly Tiercelet, Lucie Vettoretti, Maud Mousset Hovaere, Messika Messika, Michel Djibré, Nathalie Rolin, Philippe Burtin, Pierre Garçon, Saad Nseir, Xavier Valette, Christian Rabe, Eberhard Barth, Henning Ebelt, Kristina Fuest, Marcus Franz, Michael Horacek, Michael Schuster, Patrick Meybohm, Raphael Romano Bruno, Sebastian Allgäuer, Simon Dubler, Stefan J. Schaller, Stefan Schering, Stephan Steiner, Thorben Dieck, Tim Rahmel, Tobias Graf, Anastasia Koutsikou, A. Vakalos, Bogdan Raitsiou, Elli Niki Flioni, Evangelia Neou, Fotios Tsimpoukas, Γεώργιος Παπαθανάκος, Giorgos Marinakis, Ioannis Koutsodimitropoulos, Kounougeri Aikaterini, Νikoletta Ρovina, Stylliani Kourelea, Polychronis Tasioudis, V Zidianakis, Vryza Konstantinia, Zoi Aidoni, Brian Marsh, Catherine Motherway, Chris Read, Ignacio Martín‐Loeches, Andrea Cracchiolo, Aristide Morigi, Italo Calamai, Stefania Brusa, Ahmed Elhadi, Ahmed Tarek, Ala Khaled, Hazem A. Sayed Ahmed, Wesal Ali Belkhair, Alexander D. Cornet, Diederik Gommers, Dylan W. de Lange, Eva van Boven, Jasper J. Haringman, Lenneke Haas, Lettie van den Berg, Oscar Hoiting, Peter de Jager, Rik Gerritsen, Tom Dormans, Willem Dieperink, Alena Breidablik Alena Breidablik, Anita Slapgard, Anne-Karin Rime, Bente Jannestad, Britt Sjøbøe, Eva Rice, Finn H. Andersen, Hans Frank Strietzel, Jan Peter Jensen, Jørund Langørgen, Kirsti Tøien, Kristian Strand, Michael Hahn, Pål Klepstad, Aleksandra Biernacka, Anna Kluzik, Bartosz Kudliński, Dariusz Maciejewski, Dorota Studzińska, Hubert Hymczak, Jan Stefaniak, Joanna Sołek-Pastuszka, Joanna Zorska, Katarzyna Cwyl, Łukasz J. Krzych, Maciej Żukowski, Małgorzata Lipińska-Gediga, Marek Pietruszko, Mariusz Piechota, Marta Serwa, Mirosław Czuczwar, Mirosław Ziętkiewicz, Natalia Kozera, Paweł Nasiłowski, Paweł Sendur, Paweł Zatorski, Piotr Gałkin, Ryszard Gawda, Urszula Kościuczuk, Waldemar Cyrankiewicz, Wojciech Gola, Alexandre Fernandes Pinto, Ana Margarida Fernandes, Ana Rita Santos, Cristina Sousa, Inês Barros, Isabel Amorim Ferreira, Jacobo Bacariza Blanco, João Teles Carvalho, José Miguel Maia, Nuno R. Candeias, Nuno Catorze, Vladislav Belskiy, Africa Lores, Ángela Prado Mira, Catia Cillóniz, David Pérez-Torres, Emilio Maseda, Enver Rodriguez, Estefanía Prol‐Silva, Gaspar Eixarch, Gemma Gomà, Gerardo Aguilar, Gonzalo Navarro Velasco, Marián Irazábal Jaimes, Mercedes Ibarz Villamayor, Noemí Fernández, Patricia Jimeno Cubero, Sonia López‐Cuenca, Teresa Tomasa, A. SJÖQVIST, Caroline Brorsson, Fredrik Schiöler, Henrik Westberg, Jessica Nauska, Joakim Sivik, Johan Berkius, Karin Kleiven Thiringer, Lina De Geer, Sten Walther, Filippo Boroli, Joerg C. Schefold, Leila Hergafi, P. Eckert, İsmail Yıldız, Ihor Yovenko, Yuriy Nalapko, Yuriy Nalapko, Richard Pugh,

Intensive Care Unit Cognitive Disorders

Abstract Background Sepsis is one of the most frequent reasons for acute intensive care unit (ICU) admission of very old patients and mortality rates are high. However, the impact of pre-existing physical and cognitive function on long-term outcome of ICU patients ≥ 80 years old (very old intensive care patients (VIPs)) with sepsis is unclear. Objective To investigate both the short- and long-term mortality of VIPs admitted with sepsis and assess the relation of mortality with pre-existing physical and cognitive function. Design Prospective cohort study. Setting 241 ICUs from 22 European countries in a six-month period between May 2018 and May 2019. Subjects Acutely admitted ICU patients aged ≥80 years with sequential organ failure assessment (SOFA) score ≥ 2. Methods Sepsis was defined according to the sepsis 3.0 criteria. Patients with sepsis as an admission diagnosis were compared with other acutely admitted patients. In addition to patients’ characteristics, disease severity, information about comorbidity and polypharmacy and pre-existing physical and cognitive function were collected. Results Out of 3,596 acutely admitted VIPs with SOFA score ≥ 2, a group of 532 patients with sepsis were compared to other admissions. Predictors for 6-month mortality were age (per 5 years): Hazard ratio (HR, 1.16 (95% confidence interval (CI), 1.09–1.25, P < 0.0001), SOFA (per one-point): HR, 1.16 (95% CI, 1.14–1.17, P < 0.0001) and frailty (CFS > 4): HR, 1.34 (95% CI, 1.18–1.51, P < 0.0001). Conclusions There is substantial long-term mortality in VIPs admitted with sepsis. Frailty, age and disease severity were identified as predictors of long-term mortality in VIPs admitted with sepsis.