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This is a prospective analysis of patient registry data of intensive care patients. The aim is to investigate if frailty is a predictor of decline of functional status of critically ill patients during their hospital stay.
Elderly critical-ill patients with a high frailty level are becoming increasingly important in the ICU and the health system. Especially, questions about the course of the individual proceeding, withhold of therapy and level of care are controversial among caretakers, as outcome and functional independence remain still unclear in these patients.
This applies particularly in view of the fact that large studies such as VIP1 showed an inverse association of high frailty classes with short-term survival.
Our main objective in this study was to focus on functional outcome and independency measured by Barthel Index after ICU stay regarding frailty, the effect of critical care and severity and prognosis of the disease.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Critically ill patients | Critically ill patients admitted to intensive care for more than 48 hours |
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| Measure | Description | Time Frame |
|---|---|---|
| Probability not to deteriorate in functional status during the hospital stay | Analysis of the course of functional status measured by the Barthel Score sub-components transfer and ambulation during the hospital stay. The Scale ranges from 0 (no transfer) to 15 (transfer to chair and back) for transfer and from 0 (no ambulation) to 15 (coming into stand and walk 50m without supervision) for ambulation. | a median of 30 days |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Functional status before hospital admission to ICU discharge | Analysis of the change of functional status measured by the Barthel Score sub-components transfer and ambulation from before hospital admission to ICU discharge. The Scale ranges from 0 (no transfer) to 15 (transfer to chair and back) for transfer and from 0 (no ambulation) to 15 (coming into stand and walk 50m without supervision) for ambulation. |
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Inclusion Criteria:
Exclusion Criteria:
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Critically ill patients admitted to two intensive care units at a university hospital from the Department of Anesthesiology and Intensive Care in Munich, Germany.
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| Name | Affiliation | Role |
|---|---|---|
| Stefan J Schaller, MD, MHBA | Technical University of Munich | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Klinikum rechts der Isar, School of Medicine, Technical University of Munich | Munich | Bavaria | 81675 | Germany |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23395245 | Background | Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. 2013 Mar 2;381(9868):752-62. doi: 10.1016/S0140-6736(12)62167-9. Epub 2013 Feb 8. | |
| 28936626 | Background | Flaatten H, De Lange DW, Morandi A, Andersen FH, Artigas A, Bertolini G, Boumendil A, Cecconi M, Christensen S, Faraldi L, Fjolner J, Jung C, Marsh B, Moreno R, Oeyen S, Ohman CA, Pinto BB, Soliman IW, Szczeklik W, Valentin A, Watson X, Zaferidis T, Guidet B; VIP1 study group. The impact of frailty on ICU and 30-day mortality and the level of care in very elderly patients (>/= 80 years). Intensive Care Med. 2017 Dec;43(12):1820-1828. doi: 10.1007/s00134-017-4940-8. Epub 2017 Sep 21. |
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Anonymized data will be made available to other researchers on reasonable request. A data share agreement will have to be signed by both parties.
Examples of reasonable requests are:
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| ID | Term |
|---|---|
| D016638 | Critical Illness |
| D000073496 | Frailty |
| ID | Term |
|---|---|
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| a median of 20 days |
| Change in Functional status before hospital admission to hospital discharge | Analysis of the change of functional status measured by the Barthel Score sub-components transfer and ambulation from before hospital admission to hospital discharge. The Scale ranges from 0 (no transfer) to 15 (transfer to chair and back) for transfer and from 0 (no ambulation) to 15 (coming into stand and walk 50m without supervision) for ambulation. | a median of 30 days |
| ICU length of stay | Duration of stay on intensive care | a median of 11 days |
| Hospital length of stay | Duration of stay in the hospital | a median of 30 days |
| Rate of discharge disposition to home | Rate of participants being discharged home after the hospital stay. | 1 day |
| ICU mortality | Expired during the intensive care stay | a median of 11 days |
| Hospital mortality | Expired during the hospital stay | a median of 22 days |
| 28289812 | Background | Latronico N, Herridge M, Hopkins RO, Angus D, Hart N, Hermans G, Iwashyna T, Arabi Y, Citerio G, Ely EW, Hall J, Mehta S, Puntillo K, Van den Hoeven J, Wunsch H, Cook D, Dos Santos C, Rubenfeld G, Vincent JL, Van den Berghe G, Azoulay E, Needham DM. The ICM research agenda on intensive care unit-acquired weakness. Intensive Care Med. 2017 Sep;43(9):1270-1281. doi: 10.1007/s00134-017-4757-5. Epub 2017 Mar 13. |