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Frailty in ICU

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https://www.readbyqxmd.com/read/27632681/readmissions-to-intensive-care-a-prospective-multicenter-study-in-australia-and-new-zealand
#1
John D Santamaria, Graeme J Duke, David V Pilcher, D James Cooper, John Moran, Rinaldo Bellomo
OBJECTIVES: To determine factors independently associated with readmission to ICU and the independent association of readmission with subsequent mortality. DESIGN: Prospective multicenter observational study. SETTING: Forty ICUs in Australia and New Zealand. PATIENTS: Consecutive adult patients discharged alive from ICU to hospital wards between September 2009 and February 2010. INTERVENTIONS: Measurement of hospital mortality...
September 13, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27604332/prevalence-goals-of-care-and-long-term-outcomes-of-patients-with-life-limiting-illness-referred-to-a-tertiary-icu
#2
Neil R Orford, Sharyn L Milnes, Nigel Lambert, Laura Berkeley, Stephen E Lane, Nicholas Simpson, Tania Elderkin, Allison Bone, Peter Martin, Charlie Corke, Rinaldo Bellomo, Michael Bailey
OBJECTIVE: To describe the prevalence, characteristics, long-term outcomes and goals-of-care discussions of patients with objective indicators of life-limiting illnesses (LLIs) referred to the intensive care unit. DESIGN, SETTING AND PATIENTS: A prospective, observational, cohort study of all adult inpatients referred to the ICU by the medical emergency team or by direct referral, during the period 30 August 2012 to 1 February 2013, at a tertiary teaching hospital in Australia...
September 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/27486262/dementia-in-the-acute-hospital-the-prevalence-and-clinical-outcomes-of-acutely-unwell-patients-with-dementia
#3
R Briggs, A Dyer, S Nabeel, R Collins, J Doherty, T Coughlan, D O'Neill, S P Kennelly
BACKGROUND: Studies have demonstrated that a significant minority of older persons presenting to acute hospital services are cognitively impaired; however, the impact of dementia on long-term outcomes is less clear. AIM: To evaluate the prevalence of dementia, both formally diagnosed and hitherto unrecognised in a cohort of acutely unwell older adults, as well as its impact on both immediate outcomes (length of stay and in-hospital mortality) and 12-month outcomes including readmission, institutionalisation and death...
August 2, 2016: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/27484461/construction-and-internal-validation-of-a-new-mortality-risk-score-for-patients-admitted-to-the-intensive-care-unit
#4
Cristina Dólera-Moreno, Antonio Palazón-Bru, Francisco Colomina-Climent, Vicente Francisco Gil-Guillén
BACKGROUND: The existing models to predict mortality in intensive care units (ICU) present difficulties in clinical practice. OBJECTIVES: The aim of this study was to develop and internally validate a points system to predict mortality in the ICU, which can be applied instantly and with high discriminating power. METHODS: This cohort study comprised all patients admitted to the ICU in a Spanish region between January 2013 and April 2014, followed from admission to death or discharge (N=1113)...
November 2016: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/27318887/-peritoneal-dialysis-for-acute-renal-failure-rediscovery-of-an-old-modality-of-renal-replacement-therapy
#5
Belkacem Issad, Guy Rostoker, Corinne Bagnis, Gilbert Deray
Acute renal failure (ARF) in adults in the intensive care unit (ICU) often evolves in a context of multiple organ failure, which explains the high mortality rate and increase treatment needs. Among, two modalities of renal replacement therapy, peritoneal dialysis (PD) was the first modality used for the treatment of ARF in the 1950s. Today, while PD is generalized for chronic renal failure treatment, its use in the ICU is limited, particularly, due to the advent of new hemodialysis techniques and the development of continuous replacement therapy...
July 2016: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/27263535/a-prospective-multicenter-cohort-study-of-frailty-in-younger-critically-ill-patients
#6
M Bagshaw, Sumit R Majumdar, Darryl B Rolfson, Quazi Ibrahim, Robert C McDermid, H Tom Stelfox
BACKGROUND: Frailty is a multidimensional syndrome characterized by loss of physiologic and cognitive reserve that heightens vulnerability. Frailty has been well described among elderly patients (i.e., 65 years of age or older), but few studies have evaluated frailty in nonelderly patients with critical illness. We aimed to describe the prevalence, correlates, and outcomes associated with frailty among younger critically ill patients. METHODS: We conducted a prospective cohort study of 197 consecutive critically ill patients aged 50-64...
2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27241560/the-impact-of-frailty-syndrome-and-risk-scores-on-emergency-cholecystectomy-patients
#7
Laura Lorenzon, Gianluca Costa, Giulia Massa, Barbara Frezza, Francesco Stella, Genoveffa Balducci
PURPOSE: Cholecystectomy, which is one of the most common surgical procedures, is also performed in the emergency setting. A number of risk scores have been introduced in recent studies; moreover, over the last few years literature has focused on surgical patients with frailty syndrome. The aim of the present study is to evaluate whether frailty syndrome and the risk scores are correlated with morbidity, post-operative hospital stay and the ICU admission rate following emergency cholecystectomy...
January 2017: Surgery Today
https://www.readbyqxmd.com/read/27153143/use-of-the-modified-frailty-index-to-predict-30-day-morbidity-and-mortality-from-spine-surgery
#8
Rushna Ali, Jason M Schwalb, David R Nerenz, Heath J Antoine, Ilan Rubinfeld
OBJECTIVE Limited tools exist to stratify perioperative risk in patients undergoing spinal procedures. The modified frailty index (mFI) based on the Canadian Study of Health and Aging Frailty Index (CSHA-FI), constructed from standard demographic variables, has been applied to various other surgical populations for risk stratification. The authors hypothesized that it would be predictive of postoperative morbidity and mortality in patients undergoing spine surgery. METHODS The 2006-2010 National Surgical Quality Improvement Program (NSQIP) data set was accessed for patients undergoing spine surgeries based on Current Procedural Terminology (CPT) codes...
May 6, 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/27075141/predicting-performance-status-1-year-after-critical-illness-in-patients-80-years-or-older-development-of-a-multivariable-clinical-prediction-model
#9
Daren K Heyland, Henry T Stelfox, Allan Garland, Deborah Cook, Peter Dodek, Jim Kutsogiannis, Xuran Jiang, Alexis F Turgeon, Andrew G Day
OBJECTIVE: We sought to develop and internally validate a clinical prediction model to estimate the outcome of very elderly patients 12 months after being admitted to the ICU. DESIGN: Prospective, longitudinal cohort study. SETTING: Twenty-two Canadian ICUs. PATIENTS: We recruited 527 patients 80 years or older who had a medical or urgent surgical diagnosis and were admitted to an ICU for at least 24 hours. MEASUREMENTS AND MAIN RESULTS: At baseline, we completed a comprehensive geriatric assessment of enrolled patients; survival and functional status was determined 12 months later...
September 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27002968/is-frailty-a-prognostic-factor-for-critically-ill-elderly-patients
#10
Muhammet Cemal Kizilarslanoglu, Ramazan Civelek, Mustafa Kemal Kilic, Fatih Sumer, Hacer Dogan Varan, Ozgur Kara, Gunes Arik, Melda Turkoglu, Gulbin Aygencel, Zekeriya Ulger
AIM: The study aimed to investigate the effects of frailty on clinical outcomes of patients in an intensive care unit (ICU). METHODS: In this prospective study, 122 patients (59 frail, 37 pre-frail and 26 robust) were included. A frailty index (FI) derived from comprehensive geriatric assessment parameters was used for the evaluation. The FI score of ≤0.25 was considered as robust, 0.25-0.40 as pre-frail and >0.40 as frail. The prognostic effects of FI were investigated and FI and APACHE II and SOFA scores, the prognostic scores using in ICU, were compared...
March 22, 2016: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/26974547/an-exploratory-study-of-long-term-outcome-measures-in-critical-illness-survivors-construct-validity-of-physical-activity-frailty-and-health-related-quality-of-life-measures
#11
Angela S McNelly, Jai Rawal, Dinesh Shrikrishna, Nicholas S Hopkinson, John Moxham, Stephen D Harridge, Nicholas Hart, Hugh E Montgomery, Zudin A Puthucheary
OBJECTIVE: Functional capacity is commonly impaired after critical illness. We sought to clarify the relationship between objective measures of physical activity, self-reported measures of health-related quality of life, and clinician reported global functioning capacity (frailty) in such patients, as well as the impact of prior chronic disease status on these functional outcomes. DESIGN: Prospective outcome study of critical illness survivors. SETTING: Community-based follow-up...
June 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/26935019/malnutrition-assessed-by-phase-angle-determines-outcomes-in-low-risk-cardiac-surgery-patients
#12
Donata Ringaitiene, Dalia Gineityte, Vaidas Vicka, Tadas Zvirblis, Ieva Norkiene, Jurate Sipylaite, Algimantas Irnius, Juozas Ivaskevicius
BACKGROUND & AIMS: Phase angle (PA), which is obtained from bioelectrical impedance analysis (BIA), is a non-invasive method for measuring altered electrical properties of biological tissues. It has been recognised as an objective prognostic marker of disease severity and frailty. The aim of this study is to determine whether PA is a marker of malnutrition and postoperative morbidity in low operative risk patients undergoing cardiac surgery. METHODS: A prospective study was conducted in a tertiary hospital...
February 18, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/26672922/equity-of-access-to-critical-care-among-elderly-patients-in-scotland-a-national-cohort-study
#13
COMPARATIVE STUDY
Annemarie B Docherty, Niall H Anderson, Timothy S Walsh, Nazir I Lone
OBJECTIVE: To compare elderly (≥ 80 yr), older (65-79 yr), and younger (< 65 yr) ICU admissions in Scotland in relation to trends in admission rates, regional variation in admissions, ICU treatment intensity, and ICU and 1-year mortality. DESIGN: National 5-year cohort study of ICU first admissions (January 1, 2005, to December 31, 2009). SETTING: All admissions to ICUs and combined units (level 2/3 care) in Scotland captured by the Scottish Intensive Care Society Audit Group database, linked with hospital discharge data and death records...
January 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/26524075/ventilator-associated-events-in-neonates-and-children-a-new-paradigm
#14
MULTICENTER STUDY
Noelle M Cocoros, Ken Kleinman, Gregory P Priebe, James E Gray, Latania K Logan, Gitte Larsen, Julia Sammons, Philip Toltzis, Irina Miroshnik, Kelly Horan, Michael Burton, Shannon Sims, Marvin Harper, Susan Coffin, Thomas J Sandora, Susan N Hocevar, Paul A Checchia, Michael Klompas, Grace M Lee
OBJECTIVES: To identify a pediatric ventilator-associated condition definition for use in neonates and children by exploring whether potential ventilator-associated condition definitions identify patients with worse outcomes. DESIGN: Retrospective cohort study and a matched cohort analysis. SETTING: Pediatric, cardiac, and neonatal ICUs in five U.S. hospitals. PATIENTS: Children 18 years old or younger ventilated for at least 1 day...
January 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/26438206/assessing-the-utility-of-icu-admission-for-octogenarians
#15
Jose Orsini, Christa Blaak, Ben Shamian, Xavier Fonseca, Amr Salem, Yaw-Ling Chen
BACKGROUND: Advanced age is associated with increased severity of acute critical illnesses and admission to ICU. Despite advances in the support for older critically ill patients, the short- and long-term mortality rates remain substantial. The purpose of this study is to analyze the factors influencing the outcome of a geriatric population admitted to the ICU. METHODS: A single-center, prospective, observational study was conducted among all geriatric patients, 80 years or older, admitted to ICU during a 6-month study period...
August 2016: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/26306719/recovery-after-critical-illness-in-patients-aged-80-years-or-older-a-multi-center-prospective-observational-cohort-study
#16
MULTICENTER STUDY
Daren K Heyland, Allan Garland, Sean M Bagshaw, Deborah Cook, Kenneth Rockwood, Henry T Stelfox, Peter Dodek, Robert A Fowler, Alexis F Turgeon, Karen Burns, John Muscedere, Jim Kutsogiannis, Martin Albert, Sangeeta Mehta, Xuran Jiang, Andrew G Day
PURPOSE: Increasingly, very old patients are admitted to Intensive Care Units (ICUs). The objective of this study was to describe 12-month outcomes of these patients and determine which characteristics are associated with a return to baseline physical function 1 year later. METHODS: In this prospective cohort study in 22 Canadian hospitals, we recruited 610 patients aged 80 years or older who were admitted to ICU for at least 24 h. At baseline, we completed a comprehensive geriatric assessment and followed patients to determine 12-month survival and physical function...
November 2015: Intensive Care Medicine
https://www.readbyqxmd.com/read/26242367/radiographic-sarcopenia-and-self-reported-exhaustion-independently-predict-nsqip-serious-complications-after-pancreaticoduodenectomy-in-older-adults
#17
Malini D Sur, Jukes P Namm, Joshua A Hemmerich, Mary M Buschmann, Kevin K Roggin, William Dale
INTRODUCTION: Sarcopenia is linked to poor outcomes after abdominal surgery. We hypothesized that radiographic sarcopenia metrics enhance prediction of complications after pancreaticoduodenectomy (PD) when combined with clinical and frailty data. METHODS: Preoperative geriatric assessments and CT scans of patients undergoing PD were reviewed. Sarcopenia was assessed at L3 using total psoas area index (TPAI) and weighted average Hounsfield units (HU), i.e., estimates of psoas muscle volume and density...
November 2015: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/26232302/prediction-of-postoperative-complications-using-multidimensional-frailty-score-in-older-female-cancer-patients-with-american-society-of-anesthesiologists-physical-status-class-1-or-2
#18
Jung-Yeon Choi, Sol-Ji Yoon, Sun-Wook Kim, Hee-Won Jung, Kwang-Il Kim, Eunyoung Kang, Sung-Won Kim, Ho-Seong Han, Cheol-Ho Kim
BACKGROUND: Even low-risk, elderly patients are at increased risk for postoperative morbidity compared with their younger counterparts. We sought to evaluate the role of a scoring model in predicting adverse surgical outcomes in low-risk, older, female cancer patients. STUDY DESIGN: From October 2011 to May 2014, two hundred and eighty-one low-risk female patients (aged 65 years and older, American Society of Anesthesiologists class 1 or 2) undergoing curative cancer surgery were included...
September 2015: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/26096386/frailty-before-critical-illness-and-mortality-for-elderly-medicare-beneficiaries
#19
Aluko A Hope, Michelle N Gong, Carmen Guerra, Hannah Wunsch
OBJECTIVES: To estimate the effect of pre-intensive care unit (ICU) health categories on mortality during and after critical illness, focusing specifically on the effect of pre-ICU frailty on short- and long-term mortality. DESIGN: Retrospective cohort study. SETTING: Medicare claims data from 2004 to 2008. PARTICIPANTS: A nationally representative sample of elderly Medicare beneficiaries admitted to an ICU in 2005. MEASUREMENTS: Participants were classified into four pre-ICU health categories (robust, cancer, chronic organ failure, frailty) using claims data from the year before admission, allowing for assignment to multiple categories...
June 2015: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/25943611/predicting-intensive-care-and-hospital-outcome-with-the-dalhousie-clinical-frailty-scale-a-pilot-assessment
#20
C Fisher, D K Karalapillai, M Bailey, N G Glassford, R Bellomo, D Jones
Frailty may help to predict intensive care unit (ICU) patient outcome. The Dalhousie Clinical Frailty Scale (DCFS) is validated to assess frailty in ambulatory settings but has not been investigated in Australian ICUs. We conducted a prospective three-month study of patients admitted to a tertiary level ICU. Within 24 hours of ICU admission, the next of kin or nurse in charge assigned a DCFS score to the patient. Data were obtained to assess the association between frailty and patient outcome. The DCFS score was completed in 205 of 348 (59%) of eligible patient admissions...
May 2015: Anaesthesia and Intensive Care
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