Resumen
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- A nd 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.
| Idioma original | Inglés estadounidense |
|---|---|
| Páginas (desde-hasta) | 1719-1727 |
| - | 9 |
| Publicación | Age and Ageing |
| Volumen | 50 |
| N.º | 5 |
| DOI | |
| Estado | Indizado - 1 set. 2021 |
Nota bibliográfica
Publisher Copyright:© 2021 The Author(s). Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.
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En: Age and Ageing, Vol. 50, N.º 5, 01.09.2021, p. 1719-1727.
Producción científica: Artículo Científico › Artículo original › revisión exhaustiva
TY - JOUR
T1 - Frailty is associated with long-term outcome in patients with sepsis who are over 80 years old
T2 - Results from an observational study in 241 European ICUs
AU - Haas, Lenneke E.M.
AU - Boumendil, Ariane
AU - Flaatten, Hans
AU - Guidet, Bertrand
AU - Ibarz, Mercedes
AU - Jung, Christian
AU - Moreno, Rui
AU - Morandi, Alessandro
AU - Andersen, Finn H.
AU - Zafeiridis, Tilemachos
AU - Walther, Sten
AU - Oeyen, Sandra
AU - Leaver, Susannah
AU - Watson, Ximena
AU - Boulanger, Carole
AU - Szczeklik, Wojciech
AU - Schefold, Joerg C.
AU - Cecconi, Maurizio
AU - Marsh, Brian
AU - Joannidis, Michael
AU - Nalapko, Yuriy
AU - Elhadi, Muhammed
AU - Fjølner, Jesper
AU - Artigas, Antonio
AU - De Lange, Dylan W.
AU - Joannidis, Michael
AU - Eller, Philipp
AU - Helbok, Raimund
AU - Schmutz, René
AU - Nollet, Joke
AU - De Neve, Nikolaas
AU - De Buysscher, Pieter
AU - Oeyen, Sandra
AU - Swinnen, Walter
AU - Mikačić, Marijana
AU - Bastiansen, Anders
AU - Husted, Andreas
AU - Dahle, Bård E.S.
AU - Cramer, Christine
AU - Sølling, Christoffer
AU - Ørsnes, Dorthe
AU - Thomsen, Jakob Edelberg
AU - Pedersen, Jonas Juul
AU - Enevoldsen, Mathilde Hummelmose
AU - Elkmann, Thomas
AU - Kubisz-Pudelko, Agnieszka
AU - Pope, Alan
AU - Collins, Amy
AU - Raj, Ashok S.
AU - Boulanger, Carole
AU - Frey, Christian
AU - Hart, Ciaran
AU - Bolger, Clare
AU - Spray, Dominic
AU - Randell, Georgina
AU - Filipe, Helder
AU - Welters, Ingeborg D.
AU - Grecu, Irina
AU - Evans, Jane
AU - Cupitt, Jason
AU - Lord, Jenny
AU - Henning, Jeremy
AU - Jones, Joanne
AU - Ball, Jonathan
AU - North, Julie
AU - Salaunkey, Kiran
AU - De Gordoa, Laura Ortiz Ruiz
AU - Bell, Louise
AU - Balasubramaniam, Madhu
AU - Vizcaychipi, Marcela
AU - Faulkner, Maria
AU - Mupudzi, McDonald
AU - Lea-Hagerty, Megan
AU - Reay, Michael
AU - Spivey, Michael
AU - Love, Nicholas
AU - Spittle, Nick Spittle Nick
AU - White, Nigel
AU - Williams, Patricia
AU - Morgan, Patrick
AU - Wakefield, Phillipa
AU - Savine, Rachel
AU - Jacob, Reni
AU - Innes, Richard
AU - Kapoor, Ritoo
AU - Humphreys, Sally
AU - Rose, Steve
AU - Dowling, Susan
AU - Leaver, Susannah
AU - Mane, Tarkeshwari
AU - Lawton, Tom
AU - Ogbeide, Vongayi
AU - Khaliq, Waqas
AU - Baird, Yolanda
AU - Romen, Antoine
AU - Galbois, Arnaud
AU - Guidet, Bertrand
AU - Vinsonneau, Christophe
AU - Charron, Cyril
AU - Thevenin, Didier
AU - Guerot, Emmanuel
AU - Besch, Guillaume
AU - Savary, Guillaume
AU - Mentec, Hervé
AU - Chagnon, Jean Luc
AU - Rigaud, Jean Philippe
AU - Quenot, Jean Pierre
AU - Castaneray, Jeremy
AU - Rosman, Jérémy
AU - Maizel, Julien
AU - Tiercelet, Kelly
AU - Vettoretti, Lucie
AU - Hovaere, Maud Mousset
AU - Messika, Messika
AU - Djibré, Michel
AU - Rolin, Nathalie
AU - Burtin, Philippe
AU - Garcon, Pierre
AU - Nseir, Saad
AU - Valette, Xavier
AU - Rabe, Christian
AU - Barth, Eberhard
AU - Ebelt, Henning
AU - Fuest, Kristina
AU - Franz, Marcus
AU - Horacek, Michael
AU - Schuster, Michael
AU - Meybohm, Patrick
AU - Bruno, Raphael Romano
AU - Allgaüer, Sebastian
AU - Dubler, Simon
AU - Schaller, Stefan J.
AU - Schering, Stefan
AU - Steiner, Stephan
AU - Dieck, Thorben
AU - Rahmel, Tim
AU - Graf, Tobias
AU - Koutsikou, Anastasia
AU - Vakalos, Aristeidis
AU - Raitsiou, Bogdan
AU - Flioni, Elli Niki
AU - Neou, Evangelia
AU - Tsimpoukas, Fotios
AU - Papathanakos, Georgios
AU - Marinakis, Giorgos
AU - Koutsodimitropoulos, Ioannis
AU - Aikaterini, Kounougeri
AU - Rovina, Nikoletta
AU - Kourelea, Stylliani
AU - Polychronis, Tasioudis
AU - Zidianakis, Vasiiios
AU - Konstantinia, Vryza
AU - Aidoni, Zoi
AU - Motherway, Catherine
AU - Read, Chris
AU - Martin-Loeches, Ignacio
AU - Cracchiolo, Andrea Neville
AU - Morigi, Aristide
AU - Calamai, Italo
AU - Brusa, Stefania
AU - Elhadi, Ahmed
AU - Tarek, Ahmed
AU - Khaled, Ala
AU - Ahmed, Hazem
AU - Belkhair, Wesal Ali
AU - Cornet, Alexander D.
AU - Gommers, Diederik
AU - De Lange, Dylan
AU - Van Boven, Eva
AU - Haringman, Jasper
AU - Haas, Lenneke
AU - Van Den Berg, Lettie
AU - Hoiting, Oscar
AU - De Jager, Peter
AU - Gerritsen, Rik T.
AU - Dormans, Tom
AU - Dieperink, Willem
AU - Breidablik, Alena Breidablik Alena
AU - Slapgard, Anita
AU - Rime, Anne Karin
AU - Jannestad, Bente
AU - Sjøbøe, Britt
AU - Rice, Eva
AU - Andersen, Finn H.
AU - Strietzel, Hans Frank
AU - Jensen, Jan Peter
AU - Langørgen, Jørund
AU - Tøien, Kirsti
AU - Strand, Kristian
AU - Hahn, Michael
AU - Klepstad, Pål
AU - Biernacka, Aleksandra
AU - Kluzik, Anna
AU - Kudlinski, Bartosz
AU - Maciejewski, Dariusz
AU - Studzińska, Dorota
AU - Hymczak, Hubert
AU - Stefaniak, Jan
AU - Solek-Pastuszka, Joanna
AU - Zorska, Joanna
AU - Cwyl, Katarzyna
AU - Krzych, Lukasz J.
AU - Zukowski, Maciej
AU - Lipińska-Gediga, Małgorzata
AU - Pietruszko, Marek
AU - Piechota, Mariusz
AU - Serwa, Marta
AU - Czuczwar, Miroslaw
AU - Ziȩtkiewicz, Mirosław
AU - Kozera, Natalia
AU - Nasiłowski, Paweł
AU - Sendur, Paweł
AU - Zatorski, Paweł
AU - Galkin, Piotr
AU - Gawda, Ryszard
AU - Kościuczuk, Urszula
AU - Cyrankiewicz, Waldemar
AU - Gola, Wojciech
AU - Pinto, Alexandre Fernandes
AU - Fernandes, Ana Margarida
AU - Santos, Ana Rita
AU - Sousa, Cristina
AU - Barros, Inês
AU - Ferreira, Isabel Amorim
AU - Blanco, Jacobo Bacariza
AU - Carvalho, Joaõ Teles
AU - Maia, Jose
AU - Candeias, Nuno
AU - Catorze, Nuno
AU - Belskiy, Vladislav
AU - Lores, Africa
AU - Mira, Angela Prado
AU - Cilloniz, Catia
AU - Perez-Torres, David
AU - Maseda, Emilio
AU - Rodriguez, Enver
AU - Prol-Silva, Estefania
AU - Eixarch, Gaspar
AU - Gomà, Gemma
AU - Aguilar, Gerardo
AU - Velasco, Gonzalo Navarro
AU - Jaimes, Marián Irazábal
AU - Villamayor, Mercedes Ibarz
AU - Fernández, Noemí Llamas
AU - Cubero, Patricia Jimeno
AU - López-Cuenca, Sonia
AU - Tomasa, Teresa
AU - Sjöqvist, Anders
AU - Brorsson, Camilla
AU - Schiöler, Fredrik
AU - Westberg, Henrik
AU - Nauska, Jessica
AU - Sivik, Joakim
AU - Berkius, Johan
AU - Thiringer, Karin Kleiven
AU - De Geer, Lina
AU - Walther, Sten
AU - Boroli, Filippo
AU - Schefold, Joerg C.
AU - Hergafi, Leila
AU - Eckert, Philippe
AU - Ylldlz, Ismail
AU - Yovenko, Ihor
AU - Nalapko, Yuriy
AU - Pugh, Richard
N1 - Publisher Copyright: © 2021 The Author(s). Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.
PY - 2021/9/1
Y1 - 2021/9/1
N2 - 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- A nd 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.
AB - 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- A nd 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.
KW - frailty
KW - intensive care unit (ICU)
KW - mortality
KW - sepsis
KW - very old people
UR - http://www.scopus.com/inward/record.url?scp=85106318096&partnerID=8YFLogxK
U2 - 10.1093/ageing/afab036
DO - 10.1093/ageing/afab036
M3 - Original Article
C2 - 33744918
AN - SCOPUS:85106318096
SN - 0002-0729
VL - 50
SP - 1719
EP - 1727
JO - Age and Ageing
JF - Age and Ageing
IS - 5
ER -