Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/21704
Title: Frailty in very old critically ill patients in Australia and New Zealand: a population-based cohort study.
Authors: Darvall, Jai N;Bellomo, Rinaldo;Paul, Eldho;Subramaniam, Ashwin;Santamaria, John D;Bagshaw, Sean M;Rai, Sumeet;Hubbard, Ruth E;Pilcher, David
Affiliation: Austin Health, Heidelberg, Victoria, Australia
Centre for Outcome and Resource Evaluation, Australian and New Zealand Intensive Care Society, Melbourne, VIC
ANU Medical School, Australian National University, Canberra, ACT
Canberra Hospital, Canberra, ACT
Peninsula Health, Melbourne, VIC
Peninsula Clinical School, Monash University, Melbourne, VIC
Centre for Integrated Critical Care, University of Melbourne, Melbourne, VIC
Royal Melbourne Hospital, Melbourne, VIC
Centre for Integrated Critical Care, University of Melbourne, Melbourne, VIC
The Alfred Hospital, Melbourne, VIC
Monash University, Melbourne, VIC
St Vincent's Hospital Melbourne, Melbourne, VIC
University of Alberta, Edmonton, AB, Canada
Centre for Health Services Research, University of Queensland, Brisbane, QLD
Issue Date: 5-Sep-2019
EDate: 2019-09-05
Citation: The Medical journal of Australia 2019; online first: 5 September
Abstract: To explore associations between frailty (Clinical Frailty Scale score of 5 or more) in very old patients in intensive care units (ICUs) and their clinical outcomes (mortality, discharge destination). Retrospective population cohort analysis of Australian and New Zealand Intensive Care Society (ANZICS) Adult Patient Database data for all patients aged 80 years or more admitted to participating ICUs between 1 January 2017 and 31 December 2018. Primary outcome: in-hospital mortality; secondary outcomes: length of stay (hospital, ICU), re-admission to ICU during the same hospital admission, discharge destination (including new chronic care or nursing home admission). Frailty status data were available for 15 613 of 45 773 patients aged 80 years or more admitted to 178 ICUs (34%); 6203 of these patients (39.7%) were deemed frail. A smaller proportion of frail than non-frail patients were men (47% v 57%), the mean illness severity scores of frail patients were slightly higher than those of non-frail patients, and they were more frequently admitted from the emergency department (28% v 21%) or with sepsis (12% v 7%) or respiratory complications (16% v 12%). In-hospital mortality was higher for frail patients (17.6% v 8.2%; adjusted odds ratio [OR], 1.87 [95% CI, 1.65-2.11]). Median lengths of ICU and hospital stay were slightly longer for frail patients, and they were more frequently discharged to new nursing home or chronic care (4.9% v 2.8%; adjusted OR, 1.61 [95% CI, 1.34-1.95]). Many very old critically ill patients in Australia and New Zealand are frail, and frailty is associated with considerably poorer health outcomes. Routine screening of older ICU patients for frailty could improve outcome prediction and inform intensive care and community health care planning.
URI: http://ahro.austin.org.au/austinjspui/handle/1/21704
DOI: 10.5694/mja2.50329
ORCID: 0000-0001-7106-5141
0000-0002-8939-7985
0000-0002-1650-8939
PubMed URL: 31489652
Type: Journal Article
Subjects: Aged
Critical care
Health services for the aged
Intensive care
Appears in Collections:Journal articles

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