The Prevalence, risk factors and outcomes of frailty in elderly critically ill patients

Abstract

Frailty is a multidimensional syndrome of loss of physiologic and cognitive reserves resulting in increased vulnerability to adverse outcomes. This research sought to determine the prevalence, risk factors, outcomes of frailty and the association between frailty and outcomes of critically ill elderly patients in two ICUs. This study’s purpose is to assess the applicability of the CFS and MFI as screening tools in guiding ICU admission of elderly patients. This is a two centre, prospective observational study of elderly critically ill patients. Inclusion criteria were ICU patients 60 years old and older, patients or family members were able to consent and patients admitted > 24 hours in ICU. The demographic variables were assessed as risk factors and clinical characteristics were analysed as outcomes. Correlation between CFS and MFI was investigated as well. Our results showed that 30 out of 58 (51.7%) of our patients were frail. MFI was significantly higher in frail patients. No significant risk factors and outcomes of frailty were detected. Mechanical ventilation and nosocomial infection were significantly associated with frailty as mechanically ventilated patients were 7.735 times more likely to be frail and patients with nosocomial infection were 6.685 times more likely to be frail compared to patients who were not inflicted with the corresponding outcomes. Conclusion: Around half of the elderly critically ill patients were frail and significant correlation between the CFS and MFI was established. Mechanical ventilation and nosocomial infection were significantly associated with frailty. Age, sex, ethnicity, marital status, level of education and living arrangement were not determined as risk factors of frailty. ICU LOS, hospital LOS, SAPS II, source of transfer to ICU, vasoactive therapy, mechanical ventilation, RRT, blood transfusion, tracheostomy, surgery, CPR limitation of therapy, self-extubation, reintubation, nosocomial infection and mortality were not recognized as outcomes of frailty.