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The association of the Activities of Daily Living and the outcome of old intensive care patients suffering from COVID-19

2022; Springer Nature; Volume: 12; Issue: 1 Linguagem: Inglês

10.1186/s13613-022-00996-9

2110-5820

Raphael Romano Bruno, Bernhard Wernly, Hans Flaatten, Jesper Fjølner, Antonio Artigas, Philipp Heinrich Baldia, Stephan Binneboessel, Bernardo Bollen Pinto, Joerg C. Schefold, Georg Wolff, Malte Kelm, Michael Beil, Sigal Sviri, Peter Vernon van Heerden, Wojciech Szczeklik, Muhammed Elhadi, Michael Joannidis, Sandra Oeyen, Εumorfia Kondili, Brian Marsh, Jakob Wollborn, Finn H. Andersen, Rui P. Moreno, Susannah Leaver, Ariane Boumendil, Dylan W. de Lange, Bertrand Guidet, Christian Jung, Philipp Eller, Michael Joannidis, Dieter Mesotten, P. Reper, Sandra Oeyen, Walter Swinnen, Nicolas Serck, Elisabeth Dewaele, Helene Brix, Jens Brushoej, Pritpal Kumar, Helene Korvenius Nedergaard, Ida Riise Balleby, Camilla Bundesen, Maria Aagaard Hansen, Stine Uhrenholt, Henning Bundgaard, Jesper Fjølner, James Gooch, Lenka Cagova, Elizabeth Potter, Michael Reay, Miriam Davey, Mohammed Abdelshafy Abusayed, Sally Humphreys, Arnaud Galbois, Bertrand Guidet, Cyril Charron, Caroline Hauw Berlemont, Guillaume Besch, Jean‐Philippe Rigaud, Julien Maizel, Michel Djibré, Philippe Burtin, Pierre Garçon, Saad Nseir, Xavier Valette, Nica Alexandru, Nathalie Marin, Marie Vaissiere, Gaëtan Plantefève, Thierry Vanderlinden, Igor Jurcisin, Buno Mégarbane, Benjamin G. Chousterman, François Dépret, Marc Garnier, Sébastien Besset, Johanna Oziel, Alexis Ferré, Stéphane Dauger, Guillaume Dumas, Bruno Gonçalves, Lucie Vettoretti, Didier Thévenin, Stefan J. Schaller, Muhammed Kurt, Andreas Faltlhauser, Christian Meyer, Milena Milovanovic, Matthias Lutz, Gonxhe Shala, Hendrik Haake, Winfried Randerath, Anselm Kunstein, Patrick Meybohm, Stephan Steiner, Eberhard Barth, Tudor C. Poerner, Philipp Simon, Marco Lorenz, Zouhir Dindane, Karl Friedrich Kuhn, M. Welte, Ingo Voigt, Hans‐Joachim Kabitz, Jakob Wollborn, Ulrich Goebel, Sandra Emily Stoll, Detlef Kindgen‐Milles, Simon Dubler, Christian Jung, Kristina Fuest, Michael Schuster, Antonio Artigas, Francesk Mulita, Νikoletta Ρovina, Zoi Aidoni, Evangelia Chrisanthopoulou, Εumorfia Kondili, Ioannis Andrianopoulos, Martijn Groenendijk, Mirjam Evers, Lenneke van Lelyveld-Haas, Iwan A. Meynaar, Alexander D. Cornet, Marieke Zegers, Willem Dieperink, Dylan W. de Lange, Tom Dormans, Michael Hahn, Britt Sjøbøe, Hans Frank Strietzel, Theresa M. Olasveengen, Luis Romundstad, Finn H. Andersen, Anna Kluzik, Paweł Zatorski, Tomasz Drygalski, Wojciech Szczeklik, Jakub Klimkiewicz, Joanna Sołek-Pastuszka, Dariusz Onichimowski, Mirosław Czuczwar, Ryszard Gawda, Jan Stefaniak, Karina Stefańska-Wronka, Ewa Zabul, Ana Andrade Oliveira, Rui Assis, Lurdes Santos, Lurdes Santos, Filipe S. Cardoso, André Gordinho, María José Arche Banzo, Begoña Zalba-Etayo, Patricia Patricia Cubero, Jesús Priego, Gemma Gomà, Teresa Maria Tomasa-Irriguible, Susana Sancho, Aida Fernández Ferreira, Eric Mayor Vázquez, Ángela Prado Mira, Mercedes Ibarz, David A. Iglesias, S. Arias-Rivera, Fernando Frutos–Vivar, Sonia López‐Cuenca, César Aldecoa, David Pérez-Torres, Isabel Canas-Pérez, Luis Tamayo-Lomas, Cristina Díaz-Rodríguez, Pablo Ruiz de Gopegui, Nawfel Ben‐Hamouda, Andrea Roberti, Yvan Fleury, Nour Abidi, Joerg C. Schefold, Ivan Chau, Alexander Dullenkopf, Richard Pugh, Sara Smuts,

Geriatric Care and Nursing Homes

Critically ill old intensive care unit (ICU) patients suffering from Sars-CoV-2 disease (COVID-19) are at increased risk for adverse outcomes. This post hoc analysis investigates the association of the Activities of Daily Living (ADL) with the outcome in this vulnerable patient group. The COVIP study is a prospective international observational study that recruited ICU patients ≥ 70 years admitted with COVID-19 (NCT04321265). Several parameters including ADL (ADL; 0 = disability, 6 = no disability), Clinical Frailty Scale (CFS), SOFA score, intensive care treatment, ICU- and 3-month survival were recorded. A mixed-effects Weibull proportional hazard regression analyses for 3-month mortality adjusted for multiple confounders. This pre-specified analysis included 2359 patients with a documented ADL and CFS. Most patients evidenced independence in their daily living before hospital admission (80% with ADL = 6). Patients with no frailty and no disability showed the lowest, patients with frailty (CFS ≥ 5) and disability (ADL < 6) the highest 3-month mortality (52 vs. 78%, p < 0.001). ADL was independently associated with 3-month mortality (ADL as a continuous variable: aHR 0.88 (95% CI 0.82-0.94, p < 0.001). Being "disable" resulted in a significant increased risk for 3-month mortality (aHR 1.53 (95% CI 1.19-1.97, p 0.001) even after adjustment for multiple confounders. Baseline Activities of Daily Living (ADL) on admission provides additional information for outcome prediction, although most critically ill old intensive care patients suffering from COVID-19 had no restriction in their ADL prior to ICU admission. Combining frailty and disability identifies a subgroup with particularly high mortality. NCT04321265.