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Journal Article

Citation

Tipping CJ, Bilish E, Harrold M, Holland AE, Chan T, Hodgson CL. Aust. Crit. Care 2020; ePub(ePub): ePub.

Affiliation

Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic, Australia; Department of Physiotherapy, The Alfred Hospital, Melbourne, Vic, Australia. Electronic address: Carol.hodgson@monash.edu.

Copyright

(Copyright © 2020, Confederation of Australian Critical Care Nurses, Publisher Elsevier Publishing)

DOI

10.1016/j.aucc.2019.11.001

PMID

32312489

Abstract

BACKGROUND: As our population ages, older adults are increasingly exposed to trauma. Frailty could be a useful measure to identify patients at risk of a poor outcome. This study aimed to determine the impact of frailty in an Australian trauma intensive care unit (ICU) population.

METHODS: A prospective observational study of critically ill trauma patients ≥50 years of age. Frailty was determined on admission to the ICU using the frailty phenotype. Demographic and hospital data were collected, and patients were followed up at 6 and 12 months. The primary outcome was 12-month mortality, and multiple regression was used to determine associated factors.

RESULTS: One hundred thirty-eight patients were included, whose mean age was 68 years; 78.2% (108/138) were classified as major trauma (Injury Severity Score >12). Twenty-two percent (30/138) of patients were identified as frail. Patients with frailty were significantly older: however, they were less severely injured and required lower rates of surgical interventions and mechanical ventilation. Frailty was independently associated with mortality at 6 and 12 months (odds ratio: 5.9, 95% confidence interval: 1.9-18.1 and odds ratio: 7.3, 95% confidence interval: 2.5-21.9, respectively). Patients with frailty had lower measures of global functioning (Glasgow Outcome Scale-Extended frail 3 [1-5] vs nonfrail 6 [(5-7], p = 0.002) and health status (Euro Qol 5Q-5D-5L utility score 0.6 [0.5-0.7] vs 0.7 [0.6-0.9], p = 0.02) at 12 months than patients without frailty.

CONCLUSION: Frailty is a useful predictor of poor outcomes in critically ill trauma patients. REGISTRATION OF PROTOCOL NUMBER: ACTRN12615000039583.

Copyright © 2019 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.


Language: en

Keywords

Critical illness; Frailty; Intensive care unit; Trauma

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