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Vol. 43. Issue 7.
Pages 395-401 (October 2019)
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Vol. 43. Issue 7.
Pages 395-401 (October 2019)
Original
DOI: 10.1016/j.medine.2019.01.007
Frailty in patients over 65 years of age admitted to Intensive Care Units (FRAIL-ICU)
Fragilidad en pacientes mayores de 65 años ingresados en cuidados intensivos (FRAIL-ICU)
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S. López Cuencaa, L. Oteiza Lópeza,
Corresponding author
loteiza@yahoo.es

Corresponding author.
, N. Lázaro Martínb, M.M. Irazabal Jaimesc, M. Ibarz Villamayord, A. Artigase,f, J.A. Lorente Balanzaa,g,h
a Servicio de Medicina Intensiva y Grandes Quemados, Hospital Universitario de Getafe, Madrid, Spain
b Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, Spain
c Servicio de Medicina Intensiva, Hospital Universitario General de Cataluña, Barcelona, Spain
d Servicio de Medicina Intensiva, Hospital Universitario Sagrat Cor, Barcelona, Spain
e Corporación Universitaria Parc Taulí, CIBER de Enfermedades Respiratorias, Universidad Autónoma de Barcelona, Sabadell, Spain
f Departamento de Medicina Intensiva, Hospitales Universitarios Sagrado Corazón-General de Cataluña, Quirón Salud, Barcelona-San Cugat del Vallès, Spain
g CIBER de Enfermedades Respiratorias, Madrid, Spain
h Universidad Europea, Madrid, Spain
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Tables (2)
Table 1. Comparison of the baseline characteristics of the frail and non-frail patients.
Table 2. Comparison of the variables related to ICU stay.
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Abstract
Objective

To estimate the prevalence of frailty in patients admitted to the Intensive Care Unit (ICU) and its impact upon ICU mortality at 1 and 6 months.

Design

A prospective observational cohort study was carried out.

Setting

Spanish ICU.

Intervention

None.

Patients and methods

Patients65 years of age admitted to the ICU for >24h. Variables were registered upon admission, and functional status was assessed by telephone calls 1 and 6 months after discharge from the ICU.

Main study variables

Age, gender, frailty (FRAIL scale), functional status (Barthel, Lawton, Clinical Dementia Rating and NUTRIC score), days of mechanical ventilation (MV), functional score (APACHE II and SOFA), ICU mortality, and mortality 1 and 6 months after ICU discharge.

Results

A total of 132 patients were evaluated, of which 46 were frail (34.9%). Age of the frail versus non-frail patients: 78.8±7.2 and 78.6±6.4 years, respectively (P=.43); male gender: 43.8% versus 56.3% (P=.10); SOFA score: 4.7±2.9 versus 4.6±2.9 (P=.75); MV: 33.3% versus 66.7% (P=.75); days of MV: 5.6±15 versus 4.3±8.1 (P=.57); ICU mortality 13% versus 6% (P=.14), mortality at 1 month 24% versus 8% (P=.01), mortality 6 months 32% versus 15% (P=.03). Frailty is associated with mortality at one month (OR=3.5, P<.05, 95% CI (1.22–10.03) and at 6 months after discharge from the ICU (OR=2.62, P<.05, 95% CI (1.04–6.56).

Conclusions

Frailty was present in 35% of the patients admitted to the ICU, and was associated with mortality.

Keywords:
Frailty
Frail elderly
Frail scale
Critically ill
Functional status
Resumen
Objetivo

Estimar la prevalencia de fragilidad en pacientes ingresados en cuidados intensivos (UCI) y su impacto sobre la mortalidad intra UCI, al mes y a los 6 meses.

Diseño

Estudio de cohorte prospectiva.

Ámbito

UCI polivalentes españolas.

Intervención

Ninguna.

Pacientes y métodos

Pacientes65 años ingresados en UCI>24horas. Se recogieron las variables al ingreso y la situación basal por teléfono al mes y a los 6 meses del alta de UCI.

Variables de interés principal

Edad, sexo, fragilidad (escala FRAIL), situación basal (Barthel, Lawton, Clinical Dementia Rating y Nutric Score), días de ventilación mecánica (VM), escalas de gravedad (APACHE II y SOFA), mortalidad UCI, al mes y a los 6 meses del alta.

Resultados

Ciento treinta y dos pacientes, 46 frágiles (34,9%). Pacientes frágiles vs. no frágiles: 78,8±7,2 vs. 78,6±6,4 años (p=0,43), varones 43,8% vs. 56,3% (p=0,10), SOFA 4,7±2,9 vs. 4,6±2,9 (p=0,75), VM 33.3% vs. 66,7% (p=0,75), días de VM 5,6±15 vs. 4,3±8,1 (p=0,57), mortalidad UCI 13% versus 6% (p = 0,14), mortalidad al mes 24% versus 8% (p = 0,01), mortalidad 6 meses 32% versus 15% (p = 0,03). La fragilidad se asocia con la mortalidad al mes (OR = 3,5; p <0,05, IC del 95% (1,22-10,03) y a los 6 meses del alta de UCI (OR = 2,62; p <0,05, IC del 95% (1,04-6,56).

Conclusiones

La fragilidad está presente en el 35% de los pacientes ingresados en UCI, asociándose a la mortalidad.

Palabras clave:
Fragilidad
Ancianos
Escala FRAIL
Cuidados intensivos
Situación basal

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