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103. Clinical Frailty Scale (CFS) reliably stratifies octogenarians in German ICUs: a multicentre prospective cohort study

Author

Muessig, Johanna M., Nia, Amir M., Masyuk, Maryna, Lauten, Alexander, Sacher, Anne Lena, Brenner, Thorsten, Franz, Marcus, Bloos, Frank, Ebelt, Henning, Schaller, Stefan J., Fuest, Kristina, Rabe, Christian, Dieck, Thorben, Steiner, Stephan, Graf, Tobias, Jánosi, Rolf A., Meybohm, Patrick, Simon, Philipp, Utzolino, Stefan, Rahmel, Tim, Barth, Eberhard, Schuster, Michael, Kelm, Malte, and Jung, Christian

Published
2018
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104. „Intensive Care Unit-Acquired Weakness“

Author

Klawitter, Felix, Schaller, Stefan J., Söhle, Martin, Reuter, Daniel A., and Ehler, Johannes

Abstract

Hintergrund: Die „Intensive Care Unit-Acquired Weakness“ (ICU-AW) ist eine der häufigsten Ursachen für eine neuromuskuläre Dysfunktion in der Intensivmedizin. Gegenwärtig fehlen evidenzbasierte Empfehlungen zur Diagnostik, zum Monitoring und zu therapeutischen Maßnahmen. Ziel der Arbeit: Die Erfassung des derzeitigen Vorgehens bei Diagnostik, Monitoring und präventiven und therapeutischen Ansätzen bei der ICU-AW auf deutschen Intensivstationen. Material und Methoden: Onlinebefragung von 448 Mitgliedern des Wissenschaftlichen Arbeitskreises Intensivmedizin (WAKI) und des Wissenschaftlichen Arbeitskreises Neuroanästhesie (WAKNA). Ergebnisse: Insgesamt wurden 68/448 (15,2 %) Fragebogen ausgewertet. Bei 13,4 % (9/67) der Befragten existiert ein strukturiertes diagnostisches Vorgehen zur Detektion der ICU-AW. Für Screening (60/68; 88,2 %) und Verlaufsbeurteilung (57/65; 87,7 %) wird die klinische Untersuchung präferiert. Etablierte Scores, wie der „Medical Research Council sum score“ (MRC-SS) spielen für Screening und Verlaufskontrolle der ICU-AW eine untergeordnete Rolle (7/68; 10,3 % und 7/65; 10,8 %). Mobilisation (45/68; 66,2 %) und Sedativareduktion (38/68; 55,9 %) stellen die häufigsten präventiven und therapeutischen Ansätze dar. Ein Mangel an Physiotherapeuten (64/68; 94,1 %) und Pflegekräften (57/68; 83,8 %) wird als Hauptdefizit bei der Versorgung von Patienten mit ICU-AW identifiziert. Insgesamt 91,2 % (62/68) der Befragten befürworten die Erstellung evidenzbasierter Empfehlungen zur Diagnostik, zum Monitoring und zu therapeutischen Ansätzen bei ICU-AW. Diskussion: Ein einheitliches Konzept für Diagnostik, Monitoring, Prävention und Therapie der ICU-AW auf deutschen Intensivstationen fehlt weitgehend. Innovative diagnostische Ansätze könnten in Zukunft helfen, Patienten mit einem hohem Risiko für eine ICU-AW frühzeitig zu detektieren, präventive Maßnahmen einzuleiten sowie wertvolle prognostische Informationen zu gewinnen.

Published
2024
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105. Barriers and facilitators in the implementation of a prehabilitation program for frail patients aged 70 and over in Germany − perspective of health care professionals involved in the PRAEP-GO project

Author

Fuchs, Tamina, Rombey, Tanja, Kiselev, Joern, Spies, Claudia, and Schaller, Stefan

Subjects
prehabiliation, geriatrics, barriers, Physical Sciences and Mathematics, Medicine and Health Sciences, facilitators, presurgical, frailty, preoperative, preoperative exercise, frail elderly, prehabilitation programs, qualitative research
Abstract

The PRAEP-GO project investigates the (cost-)effectiveness of a prehabilitation program as a new model of care for frail adults aged 70 years and older requiring elective surgery. It is designed as a multicentre, parallel group, randomized controlled trial lead by CS and SJS [1]. Patients in the intervention group participate in an individual multimodal prehabilitation program over a period of three weeks preoperatively, while patients in the control group receive usual preoperative care. The contents of the individual prehabilitation program are determined in a shared decision-making conference involving various health care professionals as well as the patient and/or a relative. The project is funded through the innovation fund of the Federal Joint Committee [2]. This means that, if PRAEP-GO as new model of care is determined (cost-)effective, it may be suggested for nationwide implementation as part of the routine care provided under the German Statutory Health Insurance. To inform the potential nationwide implementation, qualitative interviews will be conducted with health care professionals involved in the prehabilitation process of the PRAEP-GO project. The aim of the present study is to examine the barriers and facilitators encountered in implementing and running a prehabilitation program as a new form of care for frail people aged 70 and older in Germany. The study will primarily be conducted by TIF, a Master of Public Health student at the Berlin School of Public Health, as part of her master thesis. She is supervised by TR and JK, both are investigators in the PRAEP-GO project. Sources: 1. Spies C (2020). Prehabilitation of Elderly Patients with Frailty Syndrome Before Elective Surgery (PRAEP-GO). Available from: https://clinicaltrials.gov/ct2/show/NCT04418271 2. Innovationsausschuss beim Gemeinsamen Bundesausschuss (2022). PRÄP-GO – Prähabilitation von älteren Patienten mit Gebrechlichkeitssyndrom vor elektiven Operationen. Available from: https://innovationsfonds.g-ba.de/projekte/neue-versorgungsformen/praep-go-praehabilitation-von-aelteren-patienten-mit-gebrechlichkeitssyndrom-vor-elektiven-operationen.276

Published
2022
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106. Concepts for exercise therapy in the prehabilitation of elderly patients with frailty or pre-frailty prior to elective surgery – A Scoping Review

Author

Kiselev, Joern, Drewniok, Nils, Daum, Nils, Moergeli, Rudolf, and Schaller, Stefan

Subjects
therapy modalities, Rehabilitation and Therapy, exercise, Medicine and Health Sciences, frailty, prehabilitation, scoping review, Physiotherapy, Other Rehabilitation and Therapy, older adults
Abstract

The aim of this Scoping Review is to evaluate the concept of exercise therapy in studies on prehabilitation for older patients with frailty or pre-frailty prior to elective surgery.

Published
2022
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114. Clinical and organizational factors associated with mortality during the peak of first COVID-19 wave

Author

Greco, Massimiliano, De Corte, Thomas, Ercole, Ari, Antonelli, Massimo, Azoulay, Elie, Citerio, Giuseppe, Morris, Andy Conway, De Pascale, Gennaro, Duska, Frantisek, Elbers, Paul, Einav, Sharon, Forni, Lui, Galarza, Laura, Girbes, Armand R.J., Grasselli, Giacomo, Gusarov, Vitaly, Jubb, Alasdair, Kesecioglu, Jozef, Lavinio, Andrea, Delgado, Maria Cruz Martin, Mellinghoff, Johannes, Myatra, Sheila Nainan, Ostermann, Marlies, Pellegrini, Mariangela, Póvoa, Pedro, Schaller, Stefan J., Teboul, Jean Louis, Wong, Adrian, De Waele, Jan, Cecconi, Maurizio, Bezzi, Marco, Gira, Alicia, Eller, Philipp, Hamid, Tarikul, Haque, Injamam Ull, De Buyser, Wim, Cudia, Antonella, De Backer, Daniel, Foulon, Pierre, Collin, Vincent, Van Hecke, Jolien, De Waele, Elisabeth, Van Malderen, Claire, Mesland, Jean Baptiste, Biston, Patrick, Piagnerelli, Michael, Haentjens, Lionel, De Schryver, Nicolas, NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM), Centro de Estudos de Doenças Crónicas (CEDOC), and Comprehensive Health Research Centre (CHRC) - pólo NMS

Subjects
Critical care, SARS-CoV-2, COVID-19, Pneumonia, Critical Care and Intensive Care Medicine, Surge capacity
Abstract

Funding Information: AE, FD, GDP, LG, VG, AJ, JK, AL, JM, SNM, MO, MP, MC declare no conflicts of interest. MG reports speaking fees from Baxter and Philips. TDC is supported by Research Foundation Flanders (Grant nr G085920N). MA reports Research Grant from GE, Honoraria from Fisher and Paykel, Pfizer, Orion and Gilead. GC reports grants, personal fees as Speakers’ Bureau Member and Advisory Board Member from Integra and Neuroptics, all outside the submitted work. ACM is supported by a Clinician Scientist Fellowship from the Medical Research Council (MR/V006118/1). SE declares no financial COIs and the following non-financial disclosures: Cochrane editor, American Society of Anesthesiologist data review board member. LF reports research funding from NIHR, Baxter, Ortho-Clinical Diagnostics, Exthera Medical and lecture fees from Baxter, Fresenius, Paion, all outside the submitted work. GG received payment for lectures from Getinge, Draeger Medical, Fisher&Paykel, Biotest, MSD, Gilead and unrestricted research grants from Fisher&Paykel and MSD (all unrelated to the present work). MCMD declares potential conflict of interest with BD. PP declares potential conflicts of interest with Pfizer, MSD and Gilead. SJS reports personal fees from Springer-Verlag, GmbH (Vienna, Austria) for educational commitments grants and non-financial support from ESICM (Bruxelles, Belgium), Fresenius (Germany), Liberate Medical LLC (Crestwood, USA), STIMIT AG (Nidau, Switzerland) Reactive Robotics GmbH (Munich, Germany) as well as from Technical University of Munich, Germany, from national (e.g. DGAI) and international (e.g. ESICM) medical societies (or their congress organizers) in the field of anesthesiology and intensive care, all outside the submitted work; SJS holds stocks in small amounts from Alphabeth Inc., Bayer AG, Rhön-Klinikum AG, and Siemens AG. These did not have any influence on this study. AW reports Honorarium for delivery of educational material for Vygon, GE. JLT declares potential conflict of interest with Getinge. JDW has consulted for Pfizer, MSD (honoraria paid to institution), and is a senior clinical investigator funded by the Research Foundation Flanders (FWO, Ref. 1881020N). Purpose: To accommodate the unprecedented number of critically ill patients with pneumonia caused by coronavirus disease 2019 (COVID-19) expansion of the capacity of intensive care unit (ICU) to clinical areas not previously used for critical care was necessary. We describe the global burden of COVID-19 admissions and the clinical and organizational characteristics associated with outcomes in critically ill COVID-19 patients. Methods: Multicenter, international, point prevalence study, including adult patients with SARS-CoV-2 infection confirmed by polymerase chain reaction (PCR) and a diagnosis of COVID-19 admitted to ICU between February 15th and May 15th, 2020. Results: 4994 patients from 280 ICUs in 46 countries were included. Included ICUs increased their total capacity from 4931 to 7630 beds, deploying personnel from other areas. Overall, 1986 (39.8%) patients were admitted to surge capacity beds. Invasive ventilation at admission was present in 2325 (46.5%) patients and was required during ICU stay in 85.8% of patients. 60-day mortality was 33.9% (IQR across units: 20%–50%) and ICU mortality 32.7%. Older age, invasive mechanical ventilation, and acute kidney injury (AKI) were associated with increased mortality. These associations were also confirmed specifically in mechanically ventilated patients. Admission to surge capacity beds was not associated with mortality, even after controlling for other factors. Conclusions: ICUs responded to the increase in COVID-19 patients by increasing bed availability and staff, admitting up to 40% of patients in surge capacity beds. Although mortality in this population was high, admission to a surge capacity bed was not associated with increased mortality. Older age, invasive mechanical ventilation, and AKI were identified as the strongest predictors of mortality. publishersversion published

Published
2022

115. Comparison of Different Ultrasound Methods to Assess Changes in Muscle Mass in Critically ill Patients.

Author

Fuest, Kristina E., Lanz, Hugo, Schulz, Jana, Ulm, Bernhard, Bennett, Victoria A., Grunow, Julius J., Weiss, Björn, Blobner, Manfred, and Schaller, Stefan J.

Subjects
MUSCLE mass, CRITICALLY ill patient care, INTENSIVE care units, HEALTH outcome assessment, HOSPITAL patients
Abstract

Background: Muscle ultrasound represents a promising approach to aid diagnoses of neuromuscular diseases in critically ill patients. Unfortunately, standardization of ultrasound measurements in clinical research is lacking, making direct comparisons between studies difficult. Protocols are required to assess qualitative muscle changes during an ICU stay in patients at high risk for the development of neuromuscular acquired weakness (ICUAW). Methods: We conducted a retrospective, observational analysis comprised of three prospective observational studies with the aim of diagnosing muscle changes by ultrasound measurement of the quadriceps muscle. Different protocols were used in each of the three studies. In total, 62 surgical, neurocritical care and trauma intensive care patients were serially assessed by different ultrasound protocols during the first week of critical illness. The relative change in ultrasound measurements was calculated for all possible locations, methods and sides. Comparison was obtained using mixed effect models with the location, the height and the side as influencing variables and patients as fixed effect. The relationship between variables and outcomes was assessed by multivariable regression analysis. Results: Ultrasound methods and measurement sites of the quadriceps muscles from all protocols were equally effective in detecting muscle changes. During the first week of an ICU stay, two groups were identified: patients with decreased muscle mass on ultrasound (n = 42) and a cohort with enlargement (n = 23). Hospital mortality was significantly increased in the cohort with muscle swelling (8 (19%) versus 12 (52%), p =.013). Conclusions: Different approaches of ultrasound measurement during critical-illness are equally able to detect muscle changes. While some patients have a decrease in muscle mass, others show swelling, which may result in a reduced probability of surviving the hospital stay. Causative reasons for these results still remain unclear. [ABSTRACT FROM AUTHOR]

Published
2023
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118. Core Outcome Measures for Clinical Effectiveness Trials of Nutritional and Metabolic Interventions in Critical Illness: An International Modified Delphi Consensus Study Evaluation (CONCISE)

Author

Davies, Thomas, primary, Gassel, Rob van, additional, de Poll, Marcel van, additional, Gunst, Jan, additional, Casaer, Michael, additional, Christopher, Kenneth, additional, Preiser, Jean Charles, additional, Hill, Aileen, additional, Gundogan, Kursat, additional, Reintam-Blaser, Annika, additional, Rousseau, Anne-Françoise, additional, Hodgson, Carol, additional, Needham, Dale, additional, Castro, Melina, additional, Schaller, Stefan, additional, McClelland, Thomas, additional, Pilkington, Joshua, additional, Sevin, Carla, additional, Wischmeyer, Paul, additional, Lee, Zheng Yii, additional, Govil, Deepak, additional, Li, Andrew, additional, Chapple, Lee-anne, additional, Denehy, Linda, additional, Montejo-González, Juan Carlos, additional, Taylor, Beth, additional, Bear, Danielle, additional, Pearse, Rupert, additional, McNelly, Angela, additional, Prowle, John, additional, and Puthucheary, Zudin, additional

Published
2022
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119. Effect of midodrine versus placebo on time to vasopressor discontinuation in patients with persistent hypotension in the intensive care unit (MIDAS): an international randomised clinical trial

Author

Santer, Peter, Anstey, Matthew H., Patrocínio, Maria D., Wibrow, Bradley, Teja, Bijan, Shay, Denys, Shaefi, Shahzad, Parsons, Charles S., Houle, Timothy T., Eikermann, Matthias, Ho, Kwok M., Schaller, Stefan J., Thevathasan, Tharusan, Albrecht, Lea, Grabitz, Stephanie, Chhangani, Khushi, Ng, Pauline Y., Levine, Alexander, DiBiasio, Alan, Palmer, Robert, Myers, Erina, Rauniyar, Rashmi, Sarge, Todd, Scheffenbichler, Flora, and Gupta, Alok

Subjects
medicine.medical_specialty, business.industry, Standard treatment, Midodrine, Medizin, 030208 emergency & critical care medicine, Critical Care and Intensive Care Medicine, Placebo, Intensive care unit, Article, Discontinuation, law.invention, Clinical trial, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, Randomized controlled trial, law, Anesthesia, Anesthesiology, Medicine, business, medicine.drug
Abstract

PURPOSE: ICU discharge is often delayed by a requirement for intravenous vasopressor medications to maintain normotension. We hypothesised that the administration of midodrine, an oral α(1)-adrenergic agonist, as adjunct to standard treatment shortens the duration of intravenous vasopressor requirement. METHODS: In this multicentre, randomised, controlled trial including three tertiary referral hospitals in the US and Australia, we enrolled adult patients with hypotension requiring a single-agent intravenous vasopressor for ≥24 hours. Subjects received oral midodrine (20 mg) or placebo every 8 hours in addition to standard care until cessation of intravenous vasopressors, ICU discharge, or occurrence of adverse events. The primary outcome was time to vasopressor discontinuation. Secondary outcomes included time to ICU discharge readiness, ICU and hospital lengths of stay, and ICU readmission rates. RESULTS: Between October 2012 and June 2019, 136 participants were randomised, of whom 132 received the allocated intervention and were included in the analysis (modified intention-to-treat approach). Time to vasopressor discontinuation was not different between midodrine and placebo groups (median [IQR], 23.5 [10.0–54.0] vs 22.5 [10.4–40.0] hours; difference, 1.0 hour; 95% CI, −10.4 to 12.3 hours; p=0.62). No differences in secondary endpoints were observed. Bradycardia occurred more often after midodrine administration (5 [7.6%] vs 0 [0%], p=0.02). CONCLUSION: Midodrine did not accelerate liberation from intravenous vasopressors and was not effective for the treatment of hypotension in critically ill patients. TRIAL REGISTRATION: NCT01531959, registered on February 13, 2012

Published
2020
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120. Health-related quality of life in older patients surviving ICU treatment for COVID-19: results from an international observational study of patients older than 70 years

Author

Soliman, Ivo, Leaver, Susannah, Flaatten, Hans, Fjølner, Jesper, Wernly, Bernhard, Bruno, Raphael, Artigas, Antonio, Bollen Pinto, Bernardo, Schefold, Joerg, Beil, Michael, Sviri, Sigal, van Heerden, Peter Vernon, Szczeklik, Wojciech, Elhadi, Muhammed, Joannidis, Michael, Oeyen, Sandra, Zafeiridis, Tilemachos, Wollborn, Jakob, Banzo, Maria Jose Arche, Fuest, Kristina, Marsh, Brian, Andersen, Finn, Moreno, Rui, Boumendil, Ariane, Guidet, Bertrand, Jung, Christian, de Lange, Dylan, Eller, Philipp, Mesotten, Dieter, Reper, Pascal, Swinnen, Walter, Brix, Helene, Brushoej, Jens, Villefrance, Maja, Nedergaard, Helene Korvenius, Bjerregaard, Anders Thais, Balleby, Ida Riise, Andersen, Kasper, Hansen, Maria Aagaard, Uhrenholt, Stine, Bundgaard, Helle, Mohamed, Aliae Ar Hussein, Salah, Rehab, Ali, Yasmin Khairy Nasreldin Mohamed, Wassim, Kyrillos, Elgazzar, Yumna, Tharwat, Samar, Azzam, Ahmed, Habib, Ayman Abdelmawgoad, Abosheaishaa, Hazem Maarouf, Azab, Mohammed, Galbois, Arnaud, Charron, Cyril, Guerot, Emmanuel, Besch, Guillaume, Rigaud, Jean-Philippe, Maizel, Julien, Djibré, Michel, Burtin, Philippe, Garcon, Pierre, Nseir, Saad, Valette, Xavier, Alexandru, Nica, Marin, Nathalie, Vaissiere, Marie, Plantefeve, Gaëtan, Vanderlinden, Thierry, Jurcisin, Igor, Megarbane, Bruno, Caillard, Anais, Valent, Arnaud, Garnier, Marc, Besset, Sebastien, Oziel, Johanna, Raphaelen, Jean-Herlé, Dauger, Stéphane, Dumas, Guillaume, Goncalves, Bruno, Piton, Gaël, Bruno, Raphael Romano, Kelm, Malte, Wolff, Georg, Barth, Eberhard, Goebel, Ulrich, Kunstein, Anselm, Schuster, Michael, Welte, Martin, Lutz, Matthias, Meybohm, Patrick, Steiner, Stephan, Poerner, Tudor, Haake, Hendrik, Schaller, Stefan, Kindgen-Milles, Detlef, Meyer, Christian, Kurt, Muhammed, Kuhn, Karl Friedrich, Randerath, Winfried, Dindane, Zouhir, Kabitz, Hans-Joachim, Voigt, Ingo, Shala, Gonxhe, Faltlhauser, Andreas, Rovina, Nikoletta, Aidoni, Zoi, Chrisanthopoulou, Evangelia, Papadogoulas, Antonios, Gurjar, Mohan, Mahmoodpoor, Ata, Ahmed, Abdullah Khudhur, Elsaka, Ahmed, Comellini, Vittoria, Rabha, Ahmed, Ahmed, Hazem, Namendys-Silva, Silvio, Ghannam, Abdelilah, Groenendijk, Martijn, Zegers, Marieke, Cornet, Alex, Evers, Mirjam, Haas, Lenneke, Dormans, Tom, Dieperink, Willem, Romundstad, Luis, Sjøbø, Britt, Strietzel, Hans Frank, Olasveengen, Theresa, Hahn, Michael, Czuczwar, Miroslaw, Gawda, Ryszard, Klimkiewicz, Jakub, de Lurdessantos, Maria Campos, Gordinho, André, Santos, Henrique, Assis, Rui, Oliveira, Ana Isabel Pinho, Badawy, Mohamed Raafat, Perez-Torres, David, Gomà, Gemma, Villamayor, Mercedes Ibarz, Mira, Angela Prado, Cubero, Patricia Jimeno, Rivera, Susana Arias, Tomasa, Teresa, Iglesias, David, Vázquez, Eric Mayor, Aldecoa, Cesar, Ferreira, Aida Fernández, Zalba-Etayo, Begoña, Canas-Perez, Isabel, Tamayo-Lomas, Luis, Diaz-Rodriguez, Cristina, Sancho, Susana, Priego, Jesús, Abualqumboz, Enas, Hilles, Momin Majed Yousuf, Saleh, Mahmoud, Ben-Hamouda, Nawfel, Roberti, Andrea, Dullenkopf, Alexander, Fleury, Yvan, Pinto, Bernardo Bollen, Al-Sadawi, Mohammed, Serck, Nicolas, Dewaele, Elisabeth, Kumar, Pritpal, Bundesen, Camilla, Innes, Richard, Gooch, James, Cagova, Lenka, Potter, Elizabeth, Reay, Michael, Davey, Miriam, Humphreys, Sally, Berlemont, Caroline Hauw, Chousterman, Benjamin Glenn, Dépret, François, Ferre, Alexis, Vettoretti, Lucie, Thevenin, Didier, Milovanovic, Milena, Simon, Philipp, Lorenz, Marco, Stoll, Sandra Emily, Dubler, Simon, Mulita, Francesk, Kondili, Eumorifa, Andrianopoulos, Ioannis, Meynaar, Iwan, Cornet, Alexander Daniel, Sjøbøe, Britt, Kluzik, Anna, Zatorski, Paweł, Drygalski, Tomasz, Solek-Pastuszka, Joanna, Onichimowski, Dariusz, Stefaniak, Jan, Stefanska-Wronka, Karina, Zabul, Ewa, Cardoso, Filipe Sousa, Banzo, Maria José Arche, Tomasa-Irriguible, Teresa Maria, Mira, Ángela Prado, Arias-Rivera, Susana, Frutos-Vivar, Fernando, Lopez-Cuenca, Sonia, de Gopegui, Pablo Ruiz, Abidi, Nour, Chau, Ivan, Pugh, Richard, Smuts, Sara, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Service de Réanimation Médicale [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, Optimisation thérapeutique en Neuropsychopharmacologie (OPTeN (UMR_S_1144 / U1144)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Bouchard, Mélanie, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), COVIP-study group, Eller, P., Joannidis, M., Mesotten, D., Reper, P., Oeyen, S., Swinnen, W., Brix, H., Brushoej, J., Villefrance, M., Nedergaard, H.K., Bjerregaard, A.T., Balleby, I.R., Andersen, K., Hansen, M.A., Uhrenholt, S., Bundgaard, H., Fjølner, J., Mohamed, AAH, Salah, R., Ali, YKNM, Wassim, K., Elgazzar, Y.A., Tharwat, S., Azzam, A.Y., Habib, A.A., Abosheaishaa, H.M., Azab, M.A., Leaver, S., Galbois, A., Guidet, B., Charron, C., Guerot, E., Besch, G., Rigaud, J.P., Maizel, J., Djibré, M., Burtin, P., Garcon, P., Nseir, S., Valette, X., Alexandru, N., Marin, N., Vaissiere, M., Plantefeve, G., Vanderlinden, T., Jurcisin, I., Megarbane, B., Caillard, A., Valent, A., Garnier, M., Besset, S., Oziel, J., Raphaelen, J.H., Dauger, S., Dumas, G., Goncalves, B., Piton, G., Jung, C., Bruno, R.R., Kelm, M., Wolff, G., Barth, E., Goebel, U., Kunstein, A., Schuster, M., Welte, M., Lutz, M., Meybohm, P., Steiner, S., Poerner, T., Haake, H., Schaller, S., Kindgen-Milles, D., Meyer, C., Kurt, M., Kuhn, K.F., Randerath, W., Wollborn, J., Dindane, Z., Kabitz, H.J., Voigt, I., Shala, G., Faltlhauser, A., Rovina, N., Aidoni, Z., Chrisanthopoulou, E., Papadogoulas, A., Gurjar, M., Mahmoodpoor, A., Ahmed, A.K., Marsh, B., Elsaka, A., Sviri, S., Comellini, V., Rabha, A., Ahmed, H., Namendys-Silva, S.A., Ghannam, A., Groenendijk, M., Zegers, M., de Lange, D., Cornet, A., Evers, M., Haas, L., Dormans, T., Dieperink, W., Romundstad, L., Sjøbø, B., Andersen, F.H., Strietzel, H.F., Olasveengen, T., Hahn, M., Czuczwar, M., Gawda, R., Klimkiewicz, J., de LurdesSantos, M.C., Gordinho, A., Santos, H., Assis, R., Oliveira, AIP, Badawy, M.R., Perez-Torres, D., Gomà, G., Villamayor, M.I., Mira, A.P., Cubero, P.J., Rivera, S.A., Tomasa, T., Iglesias, D., Vázquez, E.M., Aldecoa, C., Ferreira, A.F., Zalba-Etayo, B., Canas-Perez, I., Tamayo-Lomas, L., Diaz-Rodriguez, C., Sancho, S., Priego, J., Abualqumboz, EMY, Hilles, MMY, Saleh, M., Ben-HAmouda, N., Roberti, A., Dullenkopf, A., Fleury, Y., Pinto, B.B., Schefold, J.C., Al-Sadawi, M., Serck, N., Dewaele, E., Kumar, P., Bundesen, C., Innes, R., Gooch, J., Cagova, L., Potter, E., Reay, M., Davey, M., Humphreys, S., Berlemont, C.H., Chousterman, B.G., Dépret, F., Ferre, A., Vettoretti, L., Thevenin, D., Milovanovic, M., Simon, P., Lorenz, M., Stoll, S.E., Dubler, S., Fuest, K., Mulita, F., Kondili, E., Andrianopoulos, I., Meynaar, I., Cornet, A.D., Sjøbøe, B., Kluzik, A., Zatorski, P., Drygalski, T., Szczeklik, W., Solek-Pastuszka, J., Onichimowski, D., Stefaniak, J., Stefanska-Wronka, K., Zabul, E., Cardoso, F.S., Banzo, MJA, Tomasa-Irriguible, T.M., Mira, Á.P., Arias-Rivera, S., Frutos-Vivar, F., Lopez-Cuenca, S., de Gopegui, P.R., Abidi, N., Chau, I., Pugh, R., and Smuts, S.

Subjects
Aging, Activities of Daily Living, Aged, COVID-19, Humans, Intensive Care Units, Prospective Studies, Quality of Life, SARS-CoV-2, Intensive Care Unit (ICU), Older people, Survival, frailty, [SDV]Life Sciences [q-bio], SOCIETY, 610 Medicine & health, General Medicine, INTENSIVE-CARE, humanities, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], [SDV] Life Sciences [q-bio], Medicine and Health Sciences, Geriatrics and Gerontology
Abstract

Background health-related quality of life (HRQoL) is an important patient-centred outcome in patients surviving ICU admission for COVID-19. It is currently not clear which domains of the HRQoL are most affected. Objective to quantify HRQoL in order to identify areas of interventions. Design prospective observation study. Setting admissions to European ICUs between March 2020 and February 2021. Subjects patients aged 70 years or older admitted with COVID-19 disease. Methods collected determinants include SOFA-score, Clinical Frailty Scale (CFS), number and timing of ICU procedures and limitation of care, Katz Activities of Daily Living (ADL) dependence score. HRQoL was assessed at 3 months after ICU admission with the Euro-QoL-5D-5L questionnaire. An outcome of ≥4 on any of Euro-QoL-5D-5L domains was considered unfavourable. Results in total 3,140 patients from 14 European countries were included in this study. Three months after inclusion, 1,224 patients (39.0%) were alive and the EQ-5D-5L from was obtained. The CFS was associated with an increased odds ratio for an unfavourable HRQoL outcome after 3 months; OR 1.15 (95% confidence interval (CI): 0.71–1.87) for CFS 2 to OR 4.33 (95% CI: 1.57–11.9) for CFS ≧ 7. The Katz ADL was not statistically significantly associated with HRQoL after 3 months. Conclusions in critically ill old intensive care patients suffering from COVID-19, the CFS is associated with the subjectively perceived quality of life. The CFS on admission can be used to inform patients and relatives on the risk of an unfavourable qualitative outcome if such patients survive.

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2022
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121. Clinical and organizational factors associated with mortality during the peak of first COVID-19 wave: the global UNITE-COVID study

Author

Greco, M, De Corte, T, Ercole, A, Antonelli, M, Azoulay, E, Citerio, G, Morris, A, De Pascale, G, Duska, F, Elbers, P, Einav, S, Forni, L, Galarza, L, Girbes, A, Grasselli, G, Gusarov, V, Jubb, A, Kesecioglu, J, Lavinio, A, Delgado, M, Mellinghoff, J, Myatra, S, Ostermann, M, Pellegrini, M, Povoa, P, Schaller, S, Teboul, J, Wong, A, De Waele, J, Cecconi, M, Greco, Massimiliano, De Corte, Thomas, Ercole, Ari, Antonelli, Massimo, Azoulay, Elie, Citerio, Giuseppe, Morris, Andy Conway, De Pascale, Gennaro, Duska, Frantisek, Elbers, Paul, Einav, Sharon, Forni, Lui, Galarza, Laura, Girbes, Armand R J, Grasselli, Giacomo, Gusarov, Vitaly, Jubb, Alasdair, Kesecioglu, Jozef, Lavinio, Andrea, Delgado, Maria Cruz Martin, Mellinghoff, Johannes, Myatra, Sheila Nainan, Ostermann, Marlies, Pellegrini, Mariangela, Povoa, Pedro, Schaller, Stefan J, Teboul, Jean-Louis, Wong, Adrian, De Waele, Jan J, Cecconi, Maurizio, Greco, M, De Corte, T, Ercole, A, Antonelli, M, Azoulay, E, Citerio, G, Morris, A, De Pascale, G, Duska, F, Elbers, P, Einav, S, Forni, L, Galarza, L, Girbes, A, Grasselli, G, Gusarov, V, Jubb, A, Kesecioglu, J, Lavinio, A, Delgado, M, Mellinghoff, J, Myatra, S, Ostermann, M, Pellegrini, M, Povoa, P, Schaller, S, Teboul, J, Wong, A, De Waele, J, Cecconi, M, Greco, Massimiliano, De Corte, Thomas, Ercole, Ari, Antonelli, Massimo, Azoulay, Elie, Citerio, Giuseppe, Morris, Andy Conway, De Pascale, Gennaro, Duska, Frantisek, Elbers, Paul, Einav, Sharon, Forni, Lui, Galarza, Laura, Girbes, Armand R J, Grasselli, Giacomo, Gusarov, Vitaly, Jubb, Alasdair, Kesecioglu, Jozef, Lavinio, Andrea, Delgado, Maria Cruz Martin, Mellinghoff, Johannes, Myatra, Sheila Nainan, Ostermann, Marlies, Pellegrini, Mariangela, Povoa, Pedro, Schaller, Stefan J, Teboul, Jean-Louis, Wong, Adrian, De Waele, Jan J, and Cecconi, Maurizio

Abstract

Purpose: To accommodate the unprecedented number of critically ill patients with pneumonia caused by coronavirus disease 2019 (COVID-19) expansion of the capacity of intensive care unit (ICU) to clinical areas not previously used for critical care was necessary. We describe the global burden of COVID-19 admissions and the clinical and organizational characteristics associated with outcomes in critically ill COVID-19 patients. Methods: Multicenter, international, point prevalence study, including adult patients with SARS-CoV-2 infection confirmed by polymerase chain reaction (PCR) and a diagnosis of COVID-19 admitted to ICU between February 15th and May 15th, 2020. Results: 4994 patients from 280 ICUs in 46 countries were included. Included ICUs increased their total capacity from 4931 to 7630 beds, deploying personnel from other areas. Overall, 1986 (39.8%) patients were admitted to surge capacity beds. Invasive ventilation at admission was present in 2325 (46.5%) patients and was required during ICU stay in 85.8% of patients. 60-day mortality was 33.9% (IQR across units: 20%–50%) and ICU mortality 32.7%. Older age, invasive mechanical ventilation, and acute kidney injury (AKI) were associated with increased mortality. These associations were also confirmed specifically in mechanically ventilated patients. Admission to surge capacity beds was not associated with mortality, even after controlling for other factors. Conclusions: ICUs responded to the increase in COVID-19 patients by increasing bed availability and staff, admitting up to 40% of patients in surge capacity beds. Although mortality in this population was high, admission to a surge capacity bed was not associated with increased mortality. Older age, invasive mechanical ventilation, and AKI were identified as the strongest predictors of mortality.

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2022

122. The rate and assessment of muscle wasting during critical illness: a systematic review and meta-analysis

Author

Sportbiologie, Fazzini, Brigitta;Märkl, Tobias;Costas, Christos;Blobner, Manfred;Schaller, Stefan J.;Prowle, John;Puthucheary, Zudin;Wackerhage, Henning, Sportbiologie, and Fazzini, Brigitta;Märkl, Tobias;Costas, Christos;Blobner, Manfred;Schaller, Stefan J.;Prowle, John;Puthucheary, Zudin;Wackerhage, Henning

Abstract

Background: Patients with critical illness can lose more than 15% of muscle mass in one week, and this can have long-term detrimental effects. However, there is currently no synthesis of the data of intensive care unit (ICU) muscle wasting studies, so the true mean rate of muscle loss across all studies is unknown. The aim of this project was therefore to systematically synthetise data on the rate of muscle loss and to identify the methods used to measure muscle size and to synthetise data on the prevalence of ICU-acquired weakness in critically ill patients. Methods: We conducted a systematic literature search of MEDLINE, PubMed, AMED, BNI, CINAHL, and EMCARE until January 2022 (International Prospective Register of Systematic Reviews [PROSPERO] registration: CRD420222989540. We included studies with at least 20 adult critically ill patients where the investigators measured a muscle mass-related variable at two time points during the ICU stay. We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and assessed the study quality using the Newcastle-Ottawa Scale. Results: Fifty-two studies that included 3251 patients fulfilled the selection criteria. These studies investigated the rate of muscle wasting in 1773 (55%) patients and assessed ICU-acquired muscle weakness in 1478 (45%) patients. The methods used to assess muscle mass were ultrasound in 85% (n = 28/33) of the studies and computed tomography in the rest 15% (n = 5/33). During the first week of critical illness, patients lost every day -1.75% (95% CI -2.05, -1.45) of their rectus femoris thickness or -2.10% (95% CI -3.17, -1.02) of rectus femoris cross-sectional area. The overall prevalence of ICU-acquired weakness was 48% (95% CI 39%, 56%). Conclusion: On average, critically ill patients lose nearly 2% of skeletal muscle per day during the first week of ICU admission.

Published
2022

123. Core outcome measures for clinical effectiveness trials of nutritional and metabolic interventions in critical illness: an international modified Delphi consensus study evaluation (CONCISE)

Author

Davies, T.W., van Gassel, Rob R.J.J., van de Poll, Marcel M.C.G., Gunst, Jan, Casaer, Michaël Paul, Christopher, Kenneth K.B., Preiser, Jean-Charles, Hill, Aileen, Gundogan, Kürşat, Reintam Blaser, Annika, Rousseau, Anne Françoise, Hodgson, Carol C.L., Needham, Dale D.M., Castro, Melina Gouveia M., Schaller, Stefan, McClelland, T., Pilkington, James J.J., Sevin, Carla C.M., Wischmeyer, Paul Edmund, Lee, Zheng Yii, Govil, Deepak, Li, A., Chapple, Lee anne L., Denehy, Linda, Montejo González, Juan Carlos, Taylor, Beth, Bear, Danielle D.E., Pearse, Rupert M, McNelly, Angela, Prowle, John J.R., Puthucheary, Zudin Amika, Davies, T.W., van Gassel, Rob R.J.J., van de Poll, Marcel M.C.G., Gunst, Jan, Casaer, Michaël Paul, Christopher, Kenneth K.B., Preiser, Jean-Charles, Hill, Aileen, Gundogan, Kürşat, Reintam Blaser, Annika, Rousseau, Anne Françoise, Hodgson, Carol C.L., Needham, Dale D.M., Castro, Melina Gouveia M., Schaller, Stefan, McClelland, T., Pilkington, James J.J., Sevin, Carla C.M., Wischmeyer, Paul Edmund, Lee, Zheng Yii, Govil, Deepak, Li, A., Chapple, Lee anne L., Denehy, Linda, Montejo González, Juan Carlos, Taylor, Beth, Bear, Danielle D.E., Pearse, Rupert M, McNelly, Angela, Prowle, John J.R., and Puthucheary, Zudin Amika

Abstract

Background: Clinical research on nutritional and metabolic interventions in critically ill patients is heterogenous regarding time points, outcomes and measurement instruments used, impeding intervention development and data syntheses, and ultimately worsening clinical outcomes. We aimed to identify and develop a set of core outcome domains and associated measurement instruments to include in all research in critically ill patients. Methods: An updated systematic review informed a two-stage modified Delphi consensus process (domains followed by instruments). Measurement instruments for domains considered ‘essential’ were taken through the second stage of the Delphi and a subsequent consensus meeting. Results: In total, 213 participants (41 patients/caregivers, 50 clinical researchers and 122 healthcare professionals) from 24 countries contributed. Consensus was reached on time points (30 and 90 days post-randomisation). Three domains were considered ‘essential’ at 30 days (survival, physical function and Infection) and five at 90 days (survival, physical function, activities of daily living, nutritional status and muscle/nerve function). Core ‘essential’ measurement instruments reached consensus for survival and activities of daily living, and ‘recommended’ measurement instruments for physical function, nutritional status and muscle/nerve function. No consensus was reached for a measurement instrument for Infection. Four further domains met criteria for ‘recommended,’ but not ‘essential,’ to measure at 30 days post-randomisation (organ dysfunction, muscle/nerve function, nutritional status and wound healing) and three at 90 days (frailty, body composition and organ dysfunction). Conclusion: The CONCISE core outcome set is an internationally agreed minimum set of outcomes for use at 30 and 90 days post-randomisation, in nutritional and metabolic clinical research in critically ill adults., SCOPUS: ar.j, info:eu-repo/semantics/published

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2022

124. Detection of delirium by family members in the intensive care unit: Translation, Cross-Cultural adaptation and validation of the Family Confusion Assessment Method for the German-Speaking area

Author

Greindl, Stephanie; https://orcid.org/0000-0001-5930-2802, Weiss, Björn; https://orcid.org/0000-0003-3139-595X, Magnolini, Raphael, Lingg, Charlotte, Mayer, Hanna; https://orcid.org/0000-0002-7206-9432, Schaller, Stefan J; https://orcid.org/0000-0002-6683-9584, Greindl, Stephanie; https://orcid.org/0000-0001-5930-2802, Weiss, Björn; https://orcid.org/0000-0003-3139-595X, Magnolini, Raphael, Lingg, Charlotte, Mayer, Hanna; https://orcid.org/0000-0002-7206-9432, and Schaller, Stefan J; https://orcid.org/0000-0002-6683-9584

Abstract

Aim: The aim of this study was the translation, cross-cultural adaptation and validation of the Family Confusion Assessment Method in critically ill patients. Background: Delirium is a frequently unrecognized disorder in critically ill patients. Visiting family members might be the first to notice subtle changes in a patient's cognition and behaviour. The Family Confusion Assessment Method was developed to detect delirium by family members, but has not been available for the German-speaking area yet. Design: A prospective validation study was conducted between January 2020 and October 2020. Methods: The Family Confusion Assessment Method was translated into German according to the Principles of Good Practice for the Translation and Cultural Adaptation Process for Patient-Reported Outcomes. Subsequently, we compared the Family Confusion Assessment Method with the Confusion Assessment Method for the Intensive Care Unit in critically ill patients and their family members in a medical intensive care unit in Germany. Results: We included 50 dyads of critically ill patients and their family members. The prevalence of delirium measured by Confusion Assessment Method for the Intensive Care Unit was 44%. Cohen's kappa coefficient was 0.84. The German Family Confusion Assessment Method had a high sensitivity of 95.5% and specificity of 89.3%. The positive predictive value and negative predictive value were 87.5% and 96.2% respectively. Conclusions: These findings suggest that the German Family Confusion Assessment Method is an accurate assessment tool for delirium detection in the intensive care unit by family members. Furthermore, the results indicate that family members may identify delirium by the Family Confusion Assessment Method without prior training. Impact: Collaborating medical staff with patients' family members to detect delirium in the intensive care unit may lead to early recognition of delirium. Keywords: Family Confusion Assessment Method; delirium; family mem

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2022

125. Assessment and technical monitoring of nutritional status of patients in intensive and intermediate care units

Author

Weimann, Arved, primary, Hartl, Wolfgang H., additional, Adolph, Michael, additional, Angstwurm, Matthias, additional, Brunkhorst, Frank M., additional, Edel, Andreas, additional, de Heer, Geraldine, additional, Felbinger, Thomas W., additional, Goeters, Christiane, additional, Hill, Aileen, additional, Kreymann, K. Georg, additional, Mayer, Konstantin, additional, Ockenga, Johann, additional, Petros, Sirak, additional, Rümelin, Andreas, additional, Schaller, Stefan J., additional, Schneider, Andrea, additional, Stoppe, Christian, additional, and Elke, Gunnar, additional

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2022
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126. Prehabilitation of elderly frail or pre-frail patients prior to elective surgery (PRAEP-GO): study protocol for a randomized, controlled, outcome-assessor blinded trial

Author

Schaller, Stefan J, primary, Kiselev, Jörn, additional, Loidl, Verena, additional, Quentin, Wilm, additional, Schmidt, Katrin, additional, Mörgeli, Rudolf, additional, Rombey, Tanja, additional, Busse, Reinhard, additional, Mansmann, Ulrich, additional, and Spies, Claudia, additional

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2022
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128. Additional file 4 of Prehabilitation of elderly frail or pre-frail patients prior to elective surgery (PRAEP-GO): study protocol for a randomized, controlled, outcome assessor-blinded trial

Author

Schaller, Stefan J., Kiselev, Jörn, Loidl, Verena, Quentin, Wilm, Schmidt, Katrin, Mörgeli, Rudolf, Rombey, Tanja, Busse, Reinhard, Mansmann, Ulrich, and Spies, Claudia

Subjects
Data_FILES, GeneralLiterature_MISCELLANEOUS
Abstract

Additional file 4. Spirit Figure.

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2022
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129. Additional file 5 of Prehabilitation of elderly frail or pre-frail patients prior to elective surgery (PRAEP-GO): study protocol for a randomized, controlled, outcome assessor-blinded trial

Author

Schaller, Stefan J., Kiselev, Jörn, Loidl, Verena, Quentin, Wilm, Schmidt, Katrin, Mörgeli, Rudolf, Rombey, Tanja, Busse, Reinhard, Mansmann, Ulrich, and Spies, Claudia

Subjects
ComputerSystemsOrganization_COMPUTER-COMMUNICATIONNETWORKS, Data_FILES
Abstract

Additional file 5. Study protocol.

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2022
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130. Additional file 7 of Prehabilitation of elderly frail or pre-frail patients prior to elective surgery (PRAEP-GO): study protocol for a randomized, controlled, outcome assessor-blinded trial

Author

Schaller, Stefan J., Kiselev, Jörn, Loidl, Verena, Quentin, Wilm, Schmidt, Katrin, Mörgeli, Rudolf, Rombey, Tanja, Busse, Reinhard, Mansmann, Ulrich, and Spies, Claudia

Subjects
ComputingMilieux_THECOMPUTINGPROFESSION, Data_FILES, ComputingMilieux_COMPUTERSANDSOCIETY, ComputingMilieux_LEGALASPECTSOFCOMPUTING
Abstract

Additional file 7. Ethical vote.

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2022
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131. sj-docx-1-jic-10.1177_08850666221132246 - Supplemental material for Comparison of Different Ultrasound Methods to Assess Changes in Muscle Mass in Critically ill Patients

Author

Fuest, Kristina E., Lanz, Hugo, Schulz, Jana, Ulm, Bernhard, Bennett, Victoria A., Grunow, Julius J., Weiss, Björn, Blobner, Manfred, and Schaller, Stefan J.

Subjects
110203 Respiratory Diseases, FOS: Clinical medicine, 111702 Aged Health Care, FOS: Health sciences, 110305 Emergency Medicine
Abstract

Supplemental material, sj-docx-1-jic-10.1177_08850666221132246 for Comparison of Different Ultrasound Methods to Assess Changes in Muscle Mass in Critically ill Patients by Kristina E. Fuest, Hugo Lanz, Jana Schulz, Bernhard Ulm, Victoria A. Bennett, Julius J. Grunow, Björn Weiss, Manfred Blobner and Stefan J. Schaller in Journal of Intensive Care Medicine

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2022
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133. The association of the Activities of Daily Living and the outcome of old intensive care patients suffering from COVID-19

Author

Bruno, Raphael Romano, Wernly, Bernhard, Flaatten, Hans, Fjølner, Jesper, Artigas, Antonio, Baldia, Philipp Heinrich, Binneboessel, Stephan, Bollen Pinto, Bernardo, Schefold, Joerg C., Wolff, Georg, Kelm, Malte, Beil, Michael, Sviri, Sigal, van Heerden, Peter Vernon, Szczeklik, Wojciech, Elhadi, Muhammed, Joannidis, Michael, Oeyen, Sandra, Kondili, Eumorfia, Marsh, Brian, Wollborn, Jakob, Andersen, Finn H., Moreno, Rui, Leaver, Susannah, Boumendil, Ariane, De Lange, Dylan W., Guidet, Bertrand, Jung, Christian, Eller, Philipp, Mesotten, Dieter, Reper, Pascal, Swinnen, Walter, Serck, Nicolas, Dewaele, Elisabeth, Brix, Helene, Brushoej, Jens, Kumar, Pritpal, Nedergaard, Helene Korvenius, Balleby, Ida Riise, Bundesen, Camilla, Hansen, Maria Aagaard, Uhrenholt, Stine, Bundgaard, Helle, Gooch, James, Cagova, Lenka, Potter, Elizabeth, Reay, Michael, Davey, Miriam, Abusayed, Mohammed Abdelshafy, Humphreys, Sally, Galbois, Arnaud, Charron, Cyril, Berlemont, Caroline Hauw, Besch, Guillaume, Rigaud, Jean-Philippe, Maizel, Julien, Djibré, Michel, Burtin, Philippe, Garcon, Pierre, Nseir, Saad, Valette, Xavier, Alexandru, Nica, Marin, Nathalie, Vaissiere, Marie, Plantefeve, Gaëtan, Vanderlinden, Thierry, Jurcisin, Igor, Megarbane, Buno, Chousterman, Benjamin Glenn, Dépret, François, Garnier, Marc, Besset, Sebastien, Oziel, Johanna, Ferre, Alexis, Dauger, Stéphane, Dumas, Guillaume, Goncalves, Bruno, Vettoretti, Lucie, Thevenin, Didier, Schaller, Stefan, Kurt, Muhammed, Faltlhauser, Andreas, Meyer, Christian, Milovanovic, Milena, Lutz, Matthias, Shala, Gonxhe, Haake, Hendrik, Randerath, Winfried, Kunstein, Anselm, Meybohm, Patrick, Steiner, Stephan, Barth, Eberhard, Poerner, Tudor, Simon, Philipp, Lorenz, Marco, Dindane, Zouhir, Kuhn, Karl Friedrich, Welte, Martin, Voigt, Ingo, Kabitz, Hans-Joachim, Goebel, Ulrich, Stoll, Sandra Emily, Kindgen-Milles, Detlef, Dubler, Simon, Fuest, Kristina, Schuster, Michael, Papadogoulas, Antonios, Mulita, Francesk, Rovina, Nikoletta, Aidoni, Zoi, Chrisanthopoulou, Evangelia, Andrianopoulos, Ioannis, Groenendijk, Martijn, Evers, Mirjam, van Lelyveld-Haas, Lenneke, Meynaar, Iwan, Cornet, Alexander Daniel, Zegers, Marieke, Dieperink, Willem, Dormans, Tom, Hahn, Michael, Sjøbøe, Britt, Strietzel, Hans Frank, Olasveengen, Theresa, Romundstad, Luis, Kluzik, Anna, Zatorski, Paweł, Drygalski, Tomasz, Klimkiewicz, Jakub, Solek-pastuszka, Joanna, Onichimowski, Dariusz, Czuczwar, Miroslaw, Gawda, Ryszard, Stefaniak, Jan, Stefanska-Wronka, Karina, Zabul, Ewa, Oliveira, Ana Isabel Pinho, Assis, Rui, de Lurdes Campos Santos, Maria, Santos, Henrique, Cardoso, Filipe Sousa, Gordinho, André, Banzo, Maria José Arche, Zalba-Etayo, Begoña, Cubero, Patricia Patricia, Priego, Jesús, Gomà, Gemma, Tomasa-Irriguible, Teresa Maria, Sancho, Susana, Ferreira, Aida Fernández, Vázquez, Eric Mayor, Mira, Ángela Prado, Ibarz, Mercedes, Iglesias, David, Arias-Rivera, Susana, Frutos-Vivar, Fernando, Lopez-Cuenca, Sonia, Aldecoa, Cesar, Perez-Torres, David, Canas-Perez, Isabel, Tamayo-Lomas, Luis, Diaz-Rodriguez, Cristina, de Gopegui, Pablo Ruiz, Ben-Hamouda, Nawfel, Roberti, Andrea, Fleury, Yvan, Abidi, Nour, Chau, Ivan, Dullenkopf, Alexander, Pugh, Richard, Smuts, Sara, COVIP study group, [missing], Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM), COVIP study group, Eller, P., Joannidis, M., Mesotten, D., Reper, P., Oeyen, S., Swinnen, W., Serck, N., Dewaele, E., Brix, H., Brushoej, J., Kumar, P., Nedergaard, H.K., Balleby, I.R., Bundesen, C., Hansen, M.A., Uhrenholt, S., Bundgaard, H., Fjølner, J., Gooch, J., Cagova, L., Potter, E., Reay, M., Davey, M., Abusayed, M.A., Humphreys, S., Galbois, A., Guidet, B., Charron, C., Berlemont, C.H., Besch, G., Rigaud, J.P., Maizel, J., Djibré, M., Burtin, P., Garcon, P., Nseir, S., Valette, X., Alexandru, N., Marin, N., Vaissiere, M., Plantefeve, G., Vanderlinden, T., Jurcisin, I., Megarbane, B., Chousterman, B.G., Dépret, F., Garnier, M., Besset, S., Oziel, J., Ferre, A., Dauger, S., Dumas, G., Goncalves, B., Vettoretti, L., Thevenin, D., Schaller, S., Kurt, M., Faltlhauser, A., Meyer, C., Milovanovic, M., Lutz, M., Shala, G., Haake, H., Randerath, W., Kunstein, A., Meybohm, P., Steiner, S., Barth, E., Poerner, T., Simon, P., Lorenz, M., Dindane, Z., Kuhn, K.F., Welte, M., Voigt, I., Kabitz, H.J., Wollborn, J., Goebel, U., Stoll, S.E., Kindgen-Milles, D., Dubler, S., Jung, C., Fuest, K., Schuster, M., Papadogoulas, A., Mulita, F., Rovina, N., Aidoni, Z., Chrisanthopoulou, E., Kondili, E., Andrianopoulos, I., Groenendijk, M., Evers, M., van Lelyveld-Haas, L., Meynaar, I., Cornet, A.D., Zegers, M., Dieperink, W., De Lange, D.W., Dormans, T., Hahn, M., Sjøbøe, B., Strietzel, H.F., Olasveengen, T., Romundstad, L., Andersen, F.H., Kluzik, A., Zatorski, P., Drygalski, T., Szczeklik, W., Klimkiewicz, J., Solek-Pastuszka, J., Onichimowski, D., Czuczwar, M., Gawda, R., Stefaniak, J., Stefanska-Wronka, K., Zabul, E., Oliveira, AIP, Assis, R., de Lurdes Campos Santos, M., Santos, H., Cardoso, F.S., Gordinho, A., Banzo, MJA, Zalba-Etayo, B., Cubero, P.P., Priego, J., Gomà, G., Tomasa-Irriguible, T.M., Sancho, S., Ferreira, A.F., Vázquez, E.M., Mira, Á.P., Ibarz, M., Iglesias, D., Arias-Rivera, S., Frutos-Vivar, F., Lopez-Cuenca, S., Aldecoa, C., Perez-Torres, D., Canas-Perez, I., Tamayo-Lomas, L., Diaz-Rodriguez, C., de Gopegui, P.R., Ben-Hamouda, N., Roberti, A., Fleury, Y., Abidi, N., Schefold, J.C., Chau, I., Dullenkopf, A., Pugh, R., and Smuts, S.

Subjects
IMPACT, MORTALITY, ICU, Medicine and Health Sciences, ILL ELDERLY-PATIENTS, 610 Medicine & health, ddc:610, Critical Care and Intensive Care Medicine, 610 Medizin und Gesundheit, FRAILTY, human activities, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18]
Abstract

Open Access funding enabled and organized by Projekt DEAL. This study was endorsed by the ESICM. Free support for running the electronic database and was granted from the dep. of Epidemiology, University of Aarhus, Denmark. Bruno et al. Annals of Intensive Care (2022) 12:26 Page 10 of 11 The support of the study in France by a grant from Fondation Assistance Publique-Hôpitaux de Paris pour la recherche is greatly appreciated. In Norway, the study was supported by a grant from the Health Region West. In addition, the study was supported by a grant from the European Open Science Cloud (EOSC). EOSCsecretariat.eu has received funding from the European Union’s Horizon Programme call H2020-INFRAEOSC-05-2018-2019, grant agreement number 831644. This work was supported by the Collaborative Research Center SFB 1116 (German Research Foundation, DFG) and by the Forschungskommission of the Medical Faculty of the Heinrich-Heine-University Düsseldorf and No. 2020–21 to RRB for a Clinician Scientist Track. No (industry) sponsorship has been received for this investigator-initiated study. PURPOSE: Critically ill old intensive care unit (ICU) patients suffering from Sars-CoV-2 disease (COVID-19) are at increased risk for adverse outcomes. This post hoc analysis investigates the association of the Activities of Daily Living (ADL) with the outcome in this vulnerable patient group. METHODS: The COVIP study is a prospective international observational study that recruited ICU patients ≥ 70 years admitted with COVID-19 (NCT04321265). Several parameters including ADL (ADL; 0 = disability, 6 = no disability), Clinical Frailty Scale (CFS), SOFA score, intensive care treatment, ICU- and 3-month survival were recorded. A mixed-effects Weibull proportional hazard regression analyses for 3-month mortality adjusted for multiple confounders. RESULTS: This pre-specified analysis included 2359 patients with a documented ADL and CFS. Most patients evidenced independence in their daily living before hospital admission (80% with ADL = 6). Patients with no frailty and no disability showed the lowest, patients with frailty (CFS ≥ 5) and disability (ADL

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2022
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134. Additional file 1 of Mobilisation of critically ill patients receiving norepinephrine: a retrospective cohort study

Author

Lindholz, Maximilian, Schellenberg, Clara M., Grunow, Julius J., Kagerbauer, Simone, Milnik, Annette, Zickler, Daniel, Angermair, Stefan, Reißhauer, Anett, Witzenrath, Martin, Menk, Mario, Boie, Sebastian, Balzer, Felix, and Schaller, Stefan J.

Abstract

Additional file 1. Table S1. Individual elements of the Elixhauser index. Table S2. All Admission diagnoses with n > 50.

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2022
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137. Noninvasive ventilation in COVID-19 patients aged ≥ 70 years—a prospective multicentre cohort study

Author

Polok, Kamil, Fronczek, Jakub, Artigas, Antonio, Flaatten, Hans, Guidet, Bertrand, De Lange, Dylan W., Fjølner, Jesper, Leaver, Susannah, Beil, Michael, Sviri, Sigal, Bruno, Raphael Romano, Wernly, Bernhard, Bollen Pinto, Bernardo, Schefold, Joerg C., Studzińska, Dorota, Joannidis, Michael, Oeyen, Sandra, Marsh, Brian, Andersen, Finn H., Moreno, Rui, Cecconi, Maurizio, Jung, Christian, Szczeklik, Wojciech, Eller, Philipp, Mesotten, Dieter, Reper, Pascal, Swinnen, Walter, Brix, Helene, Brushoej, Jens, Villefrance, Maja, Nedergaard, Helene Korvenius, Bjerregaard, Anders Thais, Balleby, Ida Riise, Andersen, Kasper, Hansen, Maria Aagaard, Uhrenholt, Stine, Bundgaard, Helle, Hussein, Aliae A. R. Mohamed, Salah, Rehab, Ali, Yasmin Khairy NasrEldin Mohamed, Wassim, Kyrillos, Elgazzar, Yumna A., Tharwat, Samar, Azzam, Ahmed Y., habib, Ayman abdelmawgoad, Abosheaishaa, Hazem Maarouf, Azab, Mohammed A., Galbois, Arnaud, Charron, Cyril, Guerot, Emmanuel, Besch, Guillaume, Rigaud, Jean-Philippe, Maizel, Julien, Djibré, Michel, Burtin, Philippe, Garcon, Pierre, Nseir, Saad, Valette, Xavier, Alexandru, Nica, Marin, Nathalie, Vaissiere, Marie, Plantefeve, Gaëtan, Vanderlinden, Thierry, Jurcisin, Igor, Megarbane, Buno, Caillard, Anais, Valent, Arnaud, Garnier, Marc, Besset, Sebastien, Oziel, Johanna, RAPHALEN, Jean-herlé, Dauger, Stéphane, Dumas, Guillaume, Goncalves, Bruno, Piton, Gaël, Barth, Eberhard, Goebel, Ulrich, Kunstein, Anselm, Schuster, Michael, Welte, Martin, Lutz, Matthias, Meybohm, Patrick, Steiner, Stephan, Poerner, Tudor, Haake, Hendrik, Schaller, Stefan, Kindgen-Milles, Detlef, Meyer, Christian, Kurt, Muhammed, Kuhn, Karl Friedrich, Randerath, Winfried, Wollborn, Jakob, Dindane, Zouhir, Kabitz, Hans-Joachim, Voigt, Ingo, Shala, Gonxhe, Faltlhauser, Andreas, Rovina, Nikoletta, Aidoni, Zoi, Chrisanthopoulou, Evangelia, Papadogoulas, Antonios, Gurjar, Mohan, Mahmoodpoor, Ata, Ahmed, Abdullah khudhur, Elsaka, Ahmed, Comellini, Vittoria, Rabha, Ahmed, Ahmed, Hazem, Namendys-Silva, Silvio A., Ghannam, Abdelilah, Groenendijk, Martijn, Zegers, Marieke, de Lange, Dylan, Cornet, Alex, Evers, Mirjam, Haas, Lenneke, Dormans, Tom, Dieperink, Willem, Romundstad, Luis, Sjøbø, Britt, Strietzel, Hans Frank, Olasveengen, Theresa, Hahn, Michael, Czuczwar, Miroslaw, Gawda, Ryszard, Klimkiewicz, Jakub, de Lurdes Campos Santos, Maria, Gordinho, André, Santos, Henrique, Assis, Rui, Oliveira, Ana Isabel Pinho, Badawy, Mohamed Raafat, Perez-Torres, David, Gomà, Gemma, Villamayor, Mercedes Ibarz, Mira, Angela Prado, Cubero, Patricia Jimeno, Rivera, Susana Arias, Tomasa, Teresa, Iglesias, David, Vázquez, Eric Mayor, Aldecoa, Cesar, Ferreira, Aida Fernández, Zalba-Etayo, Begoña, Canas-Perez, Isabel, Tamayo-Lomas, Luis, Diaz-Rodriguez, Cristina, Sancho, Susana, Priego, Jesús, Abualqumboz, Enas M. Y., Hilles, Momin Majed Yousuf, Saleh, Mahmoud, Ben-HAmouda, Nawfel, Roberti, Andrea, Dullenkopf, Alexander, Fleury, Yvan, Al-Sadawi, Mohammed, COVIP Study Group, [missing], and NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)

Subjects
Male, Noninvasive Ventilation, Frailty, COVID-19, 610 Medicine & health, Critical Care and Intensive Care Medicine, Noninvasive Ventilation/adverse effects, Respiration, Artificial, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], Cohort Studies, Intensive Care Units, Respiratory Insufficiency/therapy, Elderly, Medicine and Health Sciences, Humans, Intensive care unit, Female, Prospective Studies, 610 Medizin und Gesundheit, Respiratory Insufficiency, Noninvasive ventilation, Pandemics, COVID-19/therapy, Aged
Abstract

Background Noninvasive ventilation (NIV) is a promising alternative to invasive mechanical ventilation (IMV) with a particular importance amidst the shortage of intensive care unit (ICU) beds during the COVID-19 pandemic. We aimed to evaluate the use of NIV in Europe and factors associated with outcomes of patients treated with NIV. Methods This is a substudy of COVIP study—an international prospective observational study enrolling patients aged ≥ 70 years with confirmed COVID-19 treated in ICU. We enrolled patients in 156 ICUs across 15 European countries between March 2020 and April 2021.The primary endpoint was 30-day mortality. Results Cohort included 3074 patients, most of whom were male (2197/3074, 71.4%) at the mean age of 75.7 years (SD 4.6). NIV frequency was 25.7% and varied from 1.1 to 62.0% between participating countries. Primary NIV failure, defined as need for endotracheal intubation or death within 30 days since ICU admission, occurred in 470/629 (74.7%) of patients. Factors associated with increased NIV failure risk were higher Sequential Organ Failure Assessment (SOFA) score (OR 3.73, 95% CI 2.36–5.90) and Clinical Frailty Scale (CFS) on admission (OR 1.46, 95% CI 1.06–2.00). Patients initially treated with NIV (n = 630) lived for 1.36 fewer days (95% CI − 2.27 to − 0.46 days) compared to primary IMV group (n = 1876). Conclusions Frequency of NIV use varies across European countries. Higher severity of illness and more severe frailty were associated with a risk of NIV failure among critically ill older adults with COVID-19. Primary IMV was associated with better outcomes than primary NIV. Clinical Trial RegistrationNCT04321265, registered 19 March 2020, https://clinicaltrials.gov.

Published
2022
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140. The Functional Trajectory in Frail Compared With Non-frail Critically Ill Patients During the Hospital Stay

Author

Fuest, K. E., primary, Lorenz, Marco, additional, Grunow, Julius J., additional, Weiss, Björn, additional, Mörgeli, Rudolf, additional, Finkenzeller, Sebastian, additional, Bogdanski, Ralph, additional, Heim, Markus, additional, Kapfer, Barbara, additional, Kriescher, Silja, additional, Lingg, Charlotte, additional, Martin, Jan, additional, Ulm, Bernhard, additional, Jungwirth, Bettina, additional, Blobner, Manfred, additional, and Schaller, Stefan J., additional

Published
2021
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142. Prevalence of hypophosphatemia in the ICU – Results of an international one-day point prevalence survey

Author

Viana Marina Verçoza, Simpson Shannon, Pereira Fernando, Rosenfeld Ricardo, Jaber Samir, Michael P Casaer, Krol Tim, Joannes-Boyau Olivier, Mette M. Berger, Fumeaux Thierry, Cheng Meisy Pérez, Reintam Blaser Annika, Pérez Gema, Karu Inga, Martinez-Alejos Roberto, A. Reintam-Blaser, Duska Frantisek, Jain Nikilesh, Alberts Erna, Samat Noryani, M. Berger Mette, Deepak Swarna, Gurjar Mohan, Jan Gunst, Kuhn Karl Friedrich, Laube Marcus, Stefan J. Schaller, Pfortmuller Carmen, Jung Veronika, Gunst Jan, Jammer Ib, Kursat Gundogan, Grand Hubert, Joel Starkopf, Keryakos Hesham Kamal Habeeb, Morris Andrew Conway, Malbrain Manu, O. Appelberg, Straka Kelly, Perez Marie-Helene, Kleger Gian-Reto, Besch Guillaume, Manrique Ezequiel, Fodor Patricia, Ichai Carole, Launey Yoann, Nicolas Mongardon, Constantin Jean-Michel, O. Joannes-Boyau, Fuest Kristina, J. Schaller Stefan, Jamme Matthieu, Marrel Julien, Van Zanten Arthur, Casaer Michael, Huq Shihan, M.E. de Man Angelique, C. Ichai, Szakmany Tamas, Tamme Kadri, Heyer Laurent, Besançon Bodolea Costel, Islam Motiul, Arroyo Abel, and Pahuja Madhu

Subjects
0301 basic medicine, Point prevalence survey, Adult, medicine.medical_specialty, Icu patients, Monitoring, Adolescent, Hypophosphatemia, Critical Care and Intensive Care Medicine, Nutrition and Dietetics, 030209 endocrinology & metabolism, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Electrolyte, medicine, Prevalence, Humans, Icu stay, Critically ill, Child, Nutrition, Aged, Aged, 80 and over, Repletion, 030109 nutrition & dietetics, business.industry, Organ dysfunction, Middle Aged, medicine.disease, Blood phosphate, Unexpected finding, Intensive Care Units, Plasma phosphate, Cross-Sectional Studies, Emergency medicine, medicine.symptom, business, Standard operating procedure
Abstract

BACKGROUND & AIMS: Hypophosphatemia (HypoP) is associated with organ dysfunction and mortality. Despite its potential severe consequences, HypoP remains poorly characterized in terms of real prevalence and timing of onset. The primary objective was to determine the prevalence of HypoP defined as blood phosphate

Published
2021

144. The impact of frailty on ICU and 30-day mortality and the level of care in very elderly patients (≥ 80 years)

Author

Flaatten, Hans, De Lange, Dylan W., Morandi, Alessandro, Andersen, Finn H., Artigas, Antonio, Bertolini, Guido, Boumendil, Ariane, Cecconi, Maurizio, Christensen, Steffen, Faraldi, Loredana, Fjølner, Jesper, Jung, Christian, Marsh, Brian, Moreno, Rui, Oeyen, Sandra, Öhman, Christina Agwald, Pinto, Bernardo Bollen, Soliman, Ivo W., Szczeklik, Wojciech, Valentin, Andreas, Watson, Ximena, Zaferidis, Tilemachos, Guidet, Bertrand, Schmutz, René, Wimmer, Franz, Eller, Philipp, Zotter, Klemens, Swinnen, Walter, De Buysscher, Pieter, De Neve, Nikolaas, Abraham, Paul, Fleury, Yvan, Schefold, Joerg C., Biskup, Ewelina, Taliadoros, Ioannis, Piza, Petr, Lauten, Alexander, Sacher, Anna Lena, Brenner, Thorsten, Franz, Marcus, Bloos, Frank, Ebelt, Henning, Schaller, Stefan J., Fuest, Kristina, Rabe, Christian, Dieck, Thorben, Steiner, Stephan, Graf, Tobias, Nia, Amir M., Janosi, Rolf Alexander, Meybohm, Patrick, Simon, Philipp, Utzolino, Stefan, Rahmel, Tim, Barth, Eberhard, Schuster, Michael, Dey, Nilanjan, Sølling, Christoffer, Rasmussen, Bodil Steen, Rodriguez, Enver, Rebollo, Sergio, Aguilar, Gerardo, Masdeu, Gaspar, Jaimes, Marián Irazábal, Prado Mira, Ángela, Bodi, Maria A., Barea Mendoza, Jesus A., López-Cuenca, Sonia, Homez Guzman, Marcela, Rico-Feijoo, Jesús, Ibarz, Mercedes, Trenado-Alvarez, Josep, Forceville, Xavier, Besch, Guillaume, Mentec, Herve, Michel, Philippe, Mateu, Philippe, Vettoretti, Lucie, Bourenne, Jeremy, Marin, Nathalie, Guillot, Max, Aissaoui, Naida, Goulenok, Cyril, Thieulot-Rolin, Nathalie, Messika, Jonathan, Lamhaut, Lionel, Charron, Cyril, Dempsey, Ged, Mathew, Shiju J., Raj, Ashok S., Grecu, Irina, Cupitt, Jason, Lawton, Tom, Clark, Richard, Popescu, Monica, Spittle, Nick, Faulkner, Maria, Cowton, Amanda, Elloway, Esme, Williams, Patricia, Reay, Michael, Chukkambotla, Srikanth, Kumar, Ravi, Al-Subaie, Nawaf, Kent, Linda, Tamm, Tiina, Kajtor, Istvan, Burns, Karen, Pugh, Richard, Ostermann, Marlies, Kam, Elisa, Bowyer, Helen, Smith, Neil, Templeton, Maie, Henning, Jeremy, Goffin, Kelly, Kapoor, Ritoo, Laha, Shondipon, Chilton, Phil, Khaliq, Waqas, Crayford, Alison, Coetzee, Samantha, Tait, Moira, Boultoukas, Evangelos, Stoker, Wendy, Gimenez, Marc, Pope, Alan, Camsooksai, Julie, Pogson, David, Quigley, Kate, Ritzema, Jenny, Hormis, Anil, Boulanger, Carole, Balasubramaniam, M., Vamplew, Luke, Burt, Karen, Martin, Daniel, Craig, Jayne, Prowle, John, Doyle, Nanci, Shelton, Jonathon, Scott, Carmen, Donnison, Phil, Shelton, Sarah, Frey, Christian, Ryan, Christine, Spray, Dominic, Barnes, Veronica, Barnes, Kerry, Furneval, Julie, Ridgway, Stephanie, Saha, Rajnish, Clark, Thomas, Wood, James, Bolger, Clare, Bassford, Christopher, Lewandowski, john, Zhao, Xiaobei, Humphreys, Sally, Dowling, Susan, Richardson, Neil, Burtenshaw, Andrew, Stevenson, Carl, Wilcock, Danielle, Aidoni, Zoi, Aloizos, Stavros, Tasioudis, Polychronis, Lampiri, Kleri, Zisopoulou, Vasiliki, Ifigenia, Ravani, Eymorfia, Pagaki, Angela, Anttoniou, Katsoulas, Theodoros A., Kyparissi, Aikaterini, Aikaterini, Kounougeri, Marinakis, George, Tsimpoukas, Fotios, Spyropoulou, Anastasia, Zygoulis, Paris, Hayes, Ivan, Kelly, Yvelynne, Westbrook, Andrew, Fitzpatrick, Gerry, Maheshwari, Darshana, Motherway, Catherine, Gupta, Manish, Gurjar, Mohan, Maji, Ismail M, Negri, Giovanni, Spadaro, Savino, Nattino, Giuseppe, Pedeferri, Matteo, Boscolo, Annalisa, Rossi, Simona, Rossi, Maurizio, Calicchio, Giuseppe, Cubattoli, Lucia, Di Lascio, Gabriella, Barbagallo, Maria, Berruto, Francesco, Codazzi, Daniela, Bottazzi, Andrea, Fumagalli, Paolo, Negro, Giancarlo, Lupi, Giuseppe, Savelli, Flavia, Vulcano, Giuseppe A., Fumagalli, Roberto, Marudi, Andrea, Lefons, Ugo, Lembo, Rita, Babini, Maria, Paggioro, Alessandra, Parrini, Vieri, Zaccaria, Maria, Clementi, Stefano, Gigliuto, Carmelo, Facondini, Francesca, Pastorini, Simonetta, Munaron, Susanna, Calamai, Italo, Bocchi, Anna, Brizio, Elisabetta, Adorni, Adele, Bocci, Maria Grazia, Cortegiani, Andrea, Casalicchio, Tiziana, Mellea, Serena, Graziani, Elia, Barattini, Massimo, van Dijk, I., van Lelyveld-Haas, L. E. M., Ramnarain, D., Jansen, Tim, Nooteboom, Fleur, van der Voort, Peter H. J., Dieperink, Willem, de Waard, Monique C., Bormans, Laura, Hahn, Michael, Kemmerer, Nicolai, Strietzel, Hans Frank, Fehrle, Lutz, Dybwik, Knut, Legernaes, Terje, Klepstad, Pål, Olaussen, Even Braut, Olsen, Knut Inge, Børresen, Ole Marius, Bjørsvik, Geir, Maini, Sameer, Czuczwar, Miroslaw, Krawczyk, Pawel, Ziętkiewicz, Mirosław, Nowak, Łukasz R., Kotfis, Katarzyna, Cwyl, Katarzyna, Gajdosz, Ryszard, Biernawska, Jowita, Grudzień, Paweł, Nasiłowski, Paweł, Popek, Natalia, Cyrankiewicz, Waldemar, Wnuk, Marek, Maciejewski, Dariusz, Studzińska, Dorota, Zukowski, Maciej, Bernas, Szymon, Serwa, Marta, Stefaniak, Jan, Pawel, Maciejewski, Szymkowiak, Malgorzata, Adamik, Barbara, Catorze, Nuno, Castelo Branco, Miguel, Barros, Inês, Barros, Nelson, Krystopchuk, Andriy, Honrado, Teresa, Sousa, Cristina, Munoz, Francisco, Rebelo, Marta, Gomes, Rui, Nunes, Jorge, Dias, Celeste, Fernandes, Ana Margarida, Petrisor, Cristina, Constantin, Bodolea, Belskiy, Vladislav, Boskholov, Boris, Kawati, Rafael, Sivik, Joakim, Nauska, Jessica, Smole, Daniel, Parenmark, Fredric, Lyrén, Johanna, Rockstroh, Katalin, Rydén, Sara, Spångfors, Martin, Strinnholm, Morten, Walther, Sten, De Geer, Lina, Nordlund, Peter, Pålsson, Staffan, Zetterquist, Harald, Nilsson, Annika, Thiringer, Karin, Jungner, Mårten, Bark, Björn, Nordling, Berit, Sköld, Hans, Brorsson, Camilla, Persson, Stefan, Bergström, Anna, Berkius, Johan, Holmström, Johanna, Yapici, Nihan, University of Bergen (UiB), Haukeland University Hospital, University Medical Center [Utrecht], CIBER de Epidemiología y Salud Pública (CIBERESP), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), St George’s University Hospitals, Aarhus University Hospital, Mater Misericordiae University Hospital (The Mater Hospital), NOVA Medical School - Faculdade de Ciências Médicas (NMS), Universidade Nova de Lisboa = NOVA University Lisbon (NOVA), Ghent University Hospital, Karolinska University Hospital [Stockholm], Hôpitaux Universitaires de Genève (HUG), Uniwersytet Jagielloński w Krakowie = Jagiellonian University (UJ), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Service de Réanimation Médicale [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Gestionnaire, Hal Sorbonne Université, Flaatten, H, De Lange, D, Morandi, A, Andersen, F, Artigas, A, Bertolini, G, Boumendil, A, Cecconi, M, Christensen, S, Faraldi, L, Fjolner, J, Jung, C, Marsh, B, Moreno, R, Oeyen, S, Ohman, C, Pinto, B, Soliman, I, Szczeklik, W, Valentin, A, Watson, X, Zaferidis, T, Guidet, B, Schmutz, R, Wimmer, F, Eller, P, Zotter, K, Swinnen, W, De Buysscher, P, De Neve, N, Abraham, P, Fleury, Y, Schefold, J, Biskup, E, Taliadoros, I, Piza, P, Lauten, A, Sacher, A, Brenner, T, Franz, M, Bloos, F, Ebelt, H, Schaller, S, Fuest, K, Rabe, C, Dieck, T, Steiner, S, Graf, T, Nia, A, Janosi, R, Meybohm, P, Simon, P, Utzolino, S, Rahmel, T, Barth, E, Schuster, M, Dey, N, Solling, C, Rasmussen, B, Rodriguez, E, Rebollo, S, Aguilar, G, Masdeu, G, Jaimes, M, Prado Mira, A, Bodi, M, Barea Mendoza, J, Lopez-Cuenca, S, Homez Guzman, M, Rico-Feijoo, J, Ibarz, M, Trenado-Alvarez, J, Forceville, X, Besch, G, Mentec, H, Michel, P, Mateu, P, Vettoretti, L, Bourenne, J, Marin, N, Guillot, M, Aissaoui, N, Goulenok, C, Thieulot-Rolin, N, Messika, J, Lamhaut, L, Charron, C, Dempsey, G, Mathew, S, Raj, A, Grecu, I, Cupitt, J, Lawton, T, Clark, R, Popescu, M, Spittle, N, Faulkner, M, Cowton, A, Elloway, E, Williams, P, Reay, M, Chukkambotla, S, Kumar, R, Al-Subaie, N, Kent, L, Tamm, T, Kajtor, I, Burns, K, Pugh, R, Ostermann, M, Kam, E, Bowyer, H, Smith, N, Templeton, M, Henning, J, Goffin, K, Kapoor, R, Laha, S, Chilton, P, Khaliq, W, Crayford, A, Coetzee, S, Tait, M, Boultoukas, E, Stoker, W, Gimenez, M, Pope, A, Camsooksai, J, Pogson, D, Quigley, K, Ritzema, J, Hormis, A, Boulanger, C, Balasubramaniam, M, Vamplew, L, Burt, K, Martin, D, Craig, J, Prowle, J, Doyle, N, Shelton, J, Scott, C, Donnison, P, Shelton, S, Frey, C, Ryan, C, Spray, D, Barnes, V, Barnes, K, Furneval, J, Ridgway, S, Saha, R, Clark, T, Wood, J, Bolger, C, Bassford, C, Lewandowski, J, Zhao, X, Humphreys, S, Dowling, S, Richardson, N, Burtenshaw, A, Stevenson, C, Wilcock, D, Aidoni, Z, Aloizos, S, Tasioudis, P, Lampiri, K, Zisopoulou, V, Ifigenia, R, Eymorfia, P, Angela, A, Katsoulas, T, Kyparissi, A, Aikaterini, K, Marinakis, G, Tsimpoukas, F, Spyropoulou, A, Zygoulis, P, Hayes, I, Kelly, Y, Westbrook, A, Fitzpatrick, G, Maheshwari, D, Motherway, C, Gupta, M, Gurjar, M, Maji, I, Negri, G, Spadaro, S, Nattino, G, Pedeferri, M, Boscolo, A, Rossi, S, Rossi, M, Calicchio, G, Cubattoli, L, Di Lascio, G, Barbagallo, M, Berruto, F, Codazzi, D, Bottazzi, A, Fumagalli, P, Negro, G, Lupi, G, Savelli, F, Vulcano, G, Fumagalli, R, Marudi, A, Lefons, U, Lembo, R, Babini, M, Paggioro, A, Parrini, V, Zaccaria, M, Clementi, S, Gigliuto, C, Facondini, F, Pastorini, S, Munaron, S, Calamai, I, Bocchi, A, Brizio, E, Adorni, A, Bocci, M, Cortegiani, A, Casalicchio, T, Mellea, S, Graziani, E, Barattini, M, van Dijk, I, van Lelyveld-Haas, L, Ramnarain, D, Jansen, T, Nooteboom, F, van der Voort, P, Dieperink, W, de Waard, M, Bormans, L, Hahn, M, Kemmerer, N, Strietzel, H, Fehrle, L, Dybwik, K, Legernaes, T, Klepstad, P, Olaussen, E, Olsen, K, Borresen, O, Bjorsvik, G, Maini, S, Czuczwar, M, Krawczyk, P, Zietkiewicz, M, Nowak, L, Kotfis, K, Cwyl, K, Gajdosz, R, Biernawska, J, Grudzien, P, Nasilowski, P, Popek, N, Cyrankiewicz, W, Wnuk, M, Maciejewski, D, Studzinska, D, Zukowski, M, Bernas, S, Serwa, M, Stefaniak, J, Pawel, M, Szymkowiak, M, Adamik, B, Catorze, N, Castelo Branco, M, Barros, I, Barros, N, Krystopchuk, A, Honrado, T, Sousa, C, Munoz, F, Rebelo, M, Gomes, R, Nunes, J, Dias, C, Fernandes, A, Petrisor, C, Constantin, B, Belskiy, V, Boskholov, B, Kawati, R, Sivik, J, Nauska, J, Smole, D, Parenmark, F, Lyren, J, Rockstroh, K, Ryden, S, Spangfors, M, Strinnholm, M, Walther, S, De Geer, L, Nordlund, P, Palsson, S, Zetterquist, H, Nilsson, A, Thiringer, K, Jungner, M, Bark, B, Nordling, B, Skold, H, Brorsson, C, Persson, S, Bergstrom, A, Berkius, J, Holmstrom, J, Yapici, N, Flaatten, Han, De Lange, Dylan W., Morandi, Alessandro, Andersen, Finn H., Artigas, Antonio, Bertolini, Guido, Boumendil, Ariane, Cecconi, Maurizio, Christensen, Steffen, Faraldi, Loredana, Fjølner, Jesper, Jung, Christian, Marsh, Brian, Moreno, Rui, Oeyen, Sandra, Öhman, Christina Agwald, Pinto, Bernardo Bollen, Soliman, Ivo W., Szczeklik, Wojciech, Valentin, Andrea, Watson, Ximena, Zaferidis, Tilemacho, Guidet, Bertrand, Schmutz, René, Wimmer, Franz, Eller, Philipp, Zotter, Klemen, Swinnen, Walter, De Buysscher, Pieter, De Neve, Nikolaa, Abraham, Paul, Fleury, Yvan, Schefold, Joerg C., Biskup, Ewelina, Taliadoros, Ioanni, Piza, Petr, Lauten, Alexander, Sacher, Anna Lena, Brenner, Thorsten, Franz, Marcu, Bloos, Frank, Ebelt, Henning, Schaller, Stefan J., Fuest, Kristina, Rabe, Christian, Dieck, Thorben, Steiner, Stephan, Graf, Tobia, Nia, Amir M., Janosi, Rolf Alexander, Meybohm, Patrick, Simon, Philipp, Utzolino, Stefan, Rahmel, Tim, Barth, Eberhard, Schuster, Michael, Dey, Nilanjan, Sølling, Christoffer, Rasmussen, Bodil Steen, Rodriguez, Enver, Rebollo, Sergio, Aguilar, Gerardo, Masdeu, Gaspar, Jaimes, Marián Irazábal, Prado Mira, Ángela, Bodi, Maria A., Barea Mendoza, Jesus A., López-Cuenca, Sonia, Homez Guzman, Marcela, Rico-Feijoo, Jesú, Ibarz, Mercede, Trenado-Alvarez, Josep, Forceville, Xavier, Besch, Guillaume, Mentec, Herve, Michel, Philippe, Mateu, Philippe, Vettoretti, Lucie, Bourenne, Jeremy, Marin, Nathalie, Guillot, Max, Aissaoui, Naida, Goulenok, Cyril, Thieulot-Rolin, Nathalie, Messika, Jonathan, Lamhaut, Lionel, Charron, Cyril, Dempsey, Ged, Mathew, Shiju J., Raj, Ashok S., Grecu, Irina, Cupitt, Jason, Lawton, Tom, Clark, Richard, Popescu, Monica, Spittle, Nick, Faulkner, Maria, Cowton, Amanda, Elloway, Esme, Williams, Patricia, Reay, Michael, Chukkambotla, Srikanth, Kumar, Ravi, Al-Subaie, Nawaf, Kent, Linda, Tamm, Tiina, Kajtor, Istvan, Burns, Karen, Pugh, Richard, Ostermann, Marlie, Kam, Elisa, Bowyer, Helen, Smith, Neil, Templeton, Maie, Henning, Jeremy, Goffin, Kelly, Kapoor, Ritoo, Laha, Shondipon, Chilton, Phil, Khaliq, Waqa, Crayford, Alison, Coetzee, Samantha, Tait, Moira, Boultoukas, Evangelo, Stoker, Wendy, Gimenez, Marc, Pope, Alan, Camsooksai, Julie, Pogson, David, Quigley, Kate, Ritzema, Jenny, Hormis, Anil, Boulanger, Carole, Balasubramaniam, M., Vamplew, Luke, Burt, Karen, Martin, Daniel, Craig, Jayne, Prowle, John, Doyle, Nanci, Shelton, Jonathon, Scott, Carmen, Donnison, Phil, Shelton, Sarah, Frey, Christian, Ryan, Christine, Spray, Dominic, Barnes, Veronica, Barnes, Kerry, Furneval, Julie, Ridgway, Stephanie, Saha, Rajnish, Clark, Thoma, Wood, Jame, Bolger, Clare, Bassford, Christopher, Lewandowski, john, Zhao, Xiaobei, Humphreys, Sally, Dowling, Susan, Richardson, Neil, Burtenshaw, Andrew, Stevenson, Carl, Wilcock, Danielle, Aidoni, Zoi, Aloizos, Stavro, Tasioudis, Polychroni, Lampiri, Kleri, Zisopoulou, Vasiliki, Ifigenia, Ravani, Eymorfia, Pagaki, Angela, Anttoniou, Katsoulas, Theodoros A., Kyparissi, Aikaterini, Aikaterini, Kounougeri, Marinakis, George, Tsimpoukas, Fotio, Spyropoulou, Anastasia, Zygoulis, Pari, Hayes, Ivan, Kelly, Yvelynne, Westbrook, Andrew, Fitzpatrick, Gerry, Maheshwari, Darshana, Motherway, Catherine, Gupta, Manish, Gurjar, Mohan, Maji, Ismail M, Negri, Giovanni, Spadaro, Savino, Nattino, Giuseppe, Pedeferri, Matteo, Boscolo, Annalisa, Rossi, Simona, Rossi, Maurizio, Calicchio, Giuseppe, Cubattoli, Lucia, Di Lascio, Gabriella, Barbagallo, Maria, Berruto, Francesco, Codazzi, Daniela, Bottazzi, Andrea, Fumagalli, Paolo, Negro, Giancarlo, Lupi, Giuseppe, Savelli, Flavia, Vulcano, Giuseppe A., Fumagalli, Roberto, Marudi, Andrea, Lefons, Ugo, Lembo, Rita, Babini, Maria, Paggioro, Alessandra, Parrini, Vieri, Zaccaria, Maria, Clementi, Stefano, Gigliuto, Carmelo, Facondini, Francesca, Pastorini, Simonetta, Munaron, Susanna, Calamai, Italo, Bocchi, Anna, Brizio, Elisabetta, Adorni, Adele, Bocci, Maria Grazia, Cortegiani, Andrea, Casalicchio, Tiziana, Mellea, Serena, Graziani, Elia, Barattini, Massimo, van Dijk, I., van Lelyveld-Haas, L.E.M., Ramnarain, D., Jansen, Tim, Nooteboom, Fleur, van der Voort, Peter H.J., Dieperink, Willem, de Waard, Monique C., Bormans, Laura, Hahn, Michael, Kemmerer, Nicolai, Strietzel, Hans Frank, Fehrle, Lutz, Dybwik, Knut, Legernaes, Terje, Klepstad, Pål, Olaussen, Even Braut, Olsen, Knut Inge, Børresen, Ole Mariu, Bjørsvik, Geir, Maini, Sameer, Czuczwar, Miroslaw, Krawczyk, Pawel, Ziętkiewicz, Mirosław, Nowak, Łukasz R., Kotfis, Katarzyna, Cwyl, Katarzyna, Gajdosz, Ryszard, Biernawska, Jowita, Grudzień, Paweł, Nasiłowski, Paweł, Popek, Natalia, Cyrankiewicz, Waldemar, Wnuk, Marek, Maciejewski, Dariusz, Studzińska, Dorota, Zukowski, Maciej, Bernas, Szymon, Serwa, Marta, Stefaniak, Jan, Pawel, Maciejewski, Szymkowiak, Malgorzata, Adamik, Barbara, Catorze, Nuno, Castelo Branco, Miguel, Barros, Inê, Barros, Nelson, Krystopchuk, Andriy, Honrado, Teresa, Sousa, Cristina, Munoz, Francisco, Rebelo, Marta, Gomes, Rui, Nunes, Jorge, Dias, Celeste, Fernandes, Ana Margarida, Petrisor, Cristina, Constantin, Bodolea, Belskiy, Vladislav, Boskholov, Bori, Kawati, Rafael, Sivik, Joakim, Nauska, Jessica, Smole, Daniel, Parenmark, Fredric, Lyrén, Johanna, Rockstroh, Katalin, Rydén, Sara, Spångfors, Martin, Strinnholm, Morten, Walther, Sten, De Geer, Lina, Nordlund, Peter, Pålsson, Staffan, Zetterquist, Harald, Nilsson, Annika, Thiringer, Karin, Jungner, Mårten, Bark, Björn, Nordling, Berit, Sköld, Han, Brorsson, Camilla, Persson, Stefan, Bergström, Anna, Berkius, Johan, Holmström, Johanna, and Yapici, Nihan

Subjects
Male, Time Factors, Outcome Assessment, Frail Elderly/statistics & numerical data, [SDV]Life Sciences [q-bio], HSJ UCI, Passive, Critical Care and Intensive Care Medicine, Frailty/classification/diagnosis/mortality/therapy, Severity of Illness Index, Severity of illne, Elderly, 0302 clinical medicine, Quality of life, Frailty, ICU, Mortality, Octogenarians, Severity of illness, Aged, 80 and over, Critical Illness, Europe, Euthanasia, Passive, Female, Frail Elderly, Geriatric Assessment, Humans, Intensive Care Units, Length of Stay, Outcome Assessment, Health Care, Proportional Hazards Models, Prospective Studies, Quality of Life, Hospital Mortality, 80 and over, 030212 general & internal medicine, Prospective cohort study, education.field_of_study, ddc:617, Mortality rate, [SDV] Life Sciences [q-bio], Length of Stay/statistics & numerical data, Cohort, Intensive Care Units/statistics & numerical data, Critical Illne, SOFA score, Human, medicine.medical_specialty, Time Factor, Intensive Care Unit, Population, INTENSIVE-CARE, Europe/epidemiology, Outcome Assessment (Health Care), 03 medical and health sciences, Octogenarian, Intensive care, Journal Article, medicine, COHORT, Octogenarinans, Intensive care medicine, education, Aged, OLDER, Euthanasia, business.industry, 030208 emergency & critical care medicine, Health Care, Prospective Studie, Critical Illness/mortality, UNIT, Emergency medicine, Proportional Hazards Model, business
Abstract

Purpose: Very old critical ill patients are a rapid expanding group in the ICU. Indications for admission, triage criteria and level of care are frequently discussed for such patients. However, most relevant outcome studies in this group frequently find an increased mortality and a reduced quality of life in survivors. The main objective was to study the impact of frailty compared with other variables with regards to short-term outcome in the very old ICU population. Methods: A transnational prospective cohort study from October 2016 to May 2017 with 30days follow-up was set up by the European Society of Intensive Care Medicine. In total 311 ICUs from 21 European countries participated. The ICUs included the first consecutive 20 very old (≥80years) patients admitted to the ICU within a 3-month inclusion period. Frailty, SOFA score and therapeutic procedures were registered, in addition to limitations of care. For measurement of frailty the Clinical Frailty Scale was used at ICU admission. The main outcomes were ICU and 30-day mortality and survival at 30days. Results: A total of 5021 patients with a median age of 84years (IQR 81–86years) were included in the final analysis, 2404 (47.9%) were women. Admission was classified as acute in 4215 (83.9%) of the patients. Overall ICU and 30-day mortality rates were 22.1% and 32.6%. During ICU stay 23.8% of the patients did not receive specific ICU procedures: ventilation, vasoactive drugs or renal replacement therapy. Frailty (values ≥5) was found in 43.1% and was independently related to 30-day survival (HR 1.54; 95% CI 1.38–1.73) for frail versus non-frail. Conclusions: Among very old patients (≥80years) admitted to the ICU, the consecutive classes in Clinical Frailty Scale were inversely associated with short-term survival. The scale had a very low number of missing data. These findings provide support to add frailty to the clinical assessment in this patient group. Trial registration: ClinicalTrials.gov (ID: NCT03134807).

Published
2017
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145. Management and outcomes in critically ill nonagenarian versus octogenarian patients

Author

Bruno, Raphael Romano, Wernly, Bernhard, Kelm, Malte, Boumendil, Ariane, Morandi, Alessandro, Andersen, Finn H., Artigas, Antonio, Finazzi, Stefano, Cecconi, Maurizio, Christensen, Steffen, Faraldi, Loredana, Lichtenauer, Michael, Muessig, Johanna M., Marsh, Brian, Moreno, Rui, Oeyen, Sandra, Öhman, Christina Agvald, Pinto, Bernardo Bollen, Soliman, Ivo W., Szczeklik, Wojciech, Valentin, Andreas, Watson, Ximena, Leaver, Susannah, Boulanger, Carole, Walther, Sten, Schefold, Joerg C., Joannidis, Michael, Nalapko, Yuriy, Elhadi, Muhammed, Fjølner, Jesper, Zafeiridis, Tilemachos, De Lange, Dylan W., Guidet, Bertrand, Flaatten, Hans, Jung, Christian, Eller, Philipp, Helbok, Raimund, Schmutz, René, Nollet, Joke, de Neve, Nikolaas, Buysscher, Pieter De, Swinnen, Walter, Mikačić, Marijana, Bastiansen, Anders, Husted, Andreas, Dahle, Bård E. S., Cramer, Christine, Sølling, Christoffer, Ørsnes, Dorthe, Thomsen, Jakob Edelberg, Pedersen, Jonas Juul, Enevoldsen, Mathilde Hummelmose, Elkmann, Thomas, Kubisz-Pudelko, Agnieszka, Pope, Alan, Collins, Amy, Raj, Ashok S., Frey, Christian, Hart, Ciaran, Bolger, Clare, Spray, Dominic, Randell, Georgina, Filipe, Helder, Welters, Ingeborg D., Grecu, Irina, Evans, Jane, Cupitt, Jason, Lord, Jenny, Henning, Jeremy, Jones, Joanne, Ball, Jonathan, North, Julie, Salaunkey, Kiran, De Gordoa, Laura Ortiz-Ruiz, Bell, Louise, Balasubramaniam, Madhu, Vizcaychipi, Marcela, Faulkner, Maria, Mupudzi, Mc Donald, Lea-Hagerty, Megan, Reay, Michael, Spivey, Michael, Love, Nicholas, Spittle, Nick Spittle Nick, White, Nigel, Williams, Patricia, Morgan, Patrick, Wakefield, Phillipa, Savine, Rachel, Jacob, Reni, Innes, Richard, Kapoor, Ritoo, Humphreys, Sally, Rose, Steve, Dowling, Susan, Mane, Tarkeshwari, Lawton, Tom, Ogbeide, Vongayi, Khaliq, Waqas, Baird, Yolanda, Romen, Antoine, Galbois, Arnaud, Vinsonneau, Christophe, Charron, Cyril, Thevenin, Didier, Guerot, Emmanuel, Besch, Guillaume, Savary, Guillaume, Mentec, Hervé, Chagnon, Jean-Luc, Rigaud, Jean-Philippe, Quenot, Jean-Pierre, Castanera, Jeremy, Rosman, Jérémy, Maizel, Julien, Tiercelet, Kelly, Vettoretti, Lucie, Hovaere, Maud Mousset, Messika, Messika, Djibré, Michel, Rolin, Nathalie, Burtin, Philippe, Garcon, Pierre, Nseir, Saad, Valette, Xavier, Rabe, Christian, Barth, Eberhard, Ebelt, Henning, Fuest, Kristina, Franz, Marcus, Horacek, Michael, Schuster, Michael, Meybohm, Patrick, Allgäuer, Sebastian, Dubler, Simon, Schaller, Stefan J., Schering, Stefan, Steiner, Stephan, Dieck, Thorben, Rahmel, Tim, Graf, Tobias, Koutsikou, Anastasia, Vakalos, Aristeidis, Raitsiou, Bogdan, Flioni, Elli Niki, Neou, Evangelia, Tsimpoukas, Fotios, Papathanakos, Georgios, Marinakis, Giorgos, Koutsodimitropoulos, Ioannis, Aikaterini, Kounougeri, Rovina, Nikoletta, Kourelea, Stylliani, Tasioudis, Polychronis, Zidianakis, Vasiiios, Konstantinia, Vryza, Aidoni, Zoi, Motherway, Catherine, Read, Chris, Martin-Loeches, Ignacio, Cracchiolo, Andrea Neville, Morigi, Aristide, Calamai, Italo, Brusa, Stefania, Elhadi, Ahmed, Tarek, Ahmed, Khaled, Ala, Ahmed, Hazem, Belkhair, Wesal Ali, Cornet, Alexander D., Gommers, Diederik, van Boven, Eva, Haringman, Jasper, Haas, Lenneke, van den Berg, Lettie, Hoiting, Oscar, de Jager, Peter, Gerritsen, Rik T., Dormans, Tom, Dieperink, Willem, Breidablik, Alena Breidablik Alena, Slapgard, Anita, Rime, Anne-Karin, Jannestad, Bente, Sjøbøe, Britt, Rice, Eva, Strietzel, Hans Frank, Jensen, Jan Peter, Langørgen, Jørund, Tøien, Kirsti, Strand, Kristian, Hahn, Michael, Klepstad, Pål, Biernacka, Aleksandra, Kluzik, Anna, Kudlinski, Bartosz, Maciejewski, Dariusz, Studzińska, Dorota, Hymczak, Hubert, Stefaniak, Jan, Solek-Pastuszka, Joanna, Zorska, Joanna, Cwyl, Katarzyna, Krzych, Lukasz J., Zukowski, Maciej, Lipińska-Gediga, Małgorzata, Pietruszko, Marek, Piechota, Mariusz, Serwa, Marta, Czuczwar, Miroslaw, Ziętkiewicz, Mirosław, Kozera, Natalia, Nasiłowski, Paweł, Sendur, Paweł, Zatorski, Paweł, Galkin, Piotr, Gawda, Ryszard, Kościuczuk, Urszula, Cyrankiewicz, Waldemar, Gola, Wojciech, Fernandes Pinto, Alexandre, Fernandes, Ana Margarida, Santos, Ana Rita, Sousa, Cristina, Barros, Inês, Ferreira, Isabel Amorim, Blanco, Jacobo Bacariza, Carvalho, João Teles, Maia, Jose, Candeias, Nuno, Catorze, Nuno, Belskiy, Vladislav, Lores, Africa, Mira, Angela Prado, Cilloniz, Catia, Perez-Torres, David, Maseda, Emilio, Rodriguez, Enver, Prol-Silva, Estefania, Eixarch, Gaspar, Gomà, Gemma, Aguilar, Gerardo, Velasco, Gonzalo Navarro, Jaimes, Marián Irazábal, Villamayor, Mercedes Ibarz, Fernández, Noemí Llamas, Cubero, Patricia Jimeno, López-Cuenca, Sonia, Tomasa, Teresa, Sjöqvist, Anders, Brorsson, Camilla, Schiöler, Fredrik, Westberg, Henrik, Nauska, Jessica, Sivik, Joakim, Berkius, Johan, Thiringer, Karin Kleiven, De Geer, Lina, Boroli, Filippo, Hergafi, Leila, Eckert, Philippe, Yıldız, Ismail, Yovenko, Ihor, Pugh, Richard, and on behalf of the VIP2 study group, [missing]

Subjects
Octogenarians, INTENSIVE-CARE-UNIT, Frailty, PREDICTION, SURGERY, MORTALITY, Nonagenarians, ICU, Medicine and Health Sciences, OLD PATIENTS, SHORT-TERM, Intensive care medicine, Geriatrics and Gerontology, ELDERLY-PATIENTS, Outcome
Abstract

Background: Intensive care unit (ICU) patients age 90 years or older represent a growing subgroup and place a huge financial burden on health care resources despite the benefit being unclear. This leads to ethical problems. The present investigation assessed the differences in outcome between nonagenarian and octogenarian ICU patients. Methods: We included 7900 acutely admitted older critically ill patients from two large, multinational studies. The primary outcome was 30-day-mortality, and the secondary outcome was ICU-mortality. Baseline characteristics consisted of frailty assessed by the Clinical Frailty Scale (CFS), ICU-management, and outcomes were compared between octogenarian (80-89.9 years) and nonagenarian (>= 90 years) patients. We used multilevel logistic regression to evaluate differences between octogenarians and nonagenarians. Results: The nonagenarians were 10% of the entire cohort. They experienced a higher percentage of frailty (58% vs 42%; p < 0.001), but lower SOFA scores at admission (6 +/- 5 vs. 7 +/- 6; p < 0.001). ICU-management strategies were different. Octogenarians required higher rates of organ support and nonagenarians received higher rates of life-sustaining treatment limitations (40% vs. 33%; p < 0.001). ICU mortality was comparable (27% vs. 27%; p = 0.973) but a higher 30-day-mortality (45% vs. 40%; p = 0.029) was seen in the nonagenarians. After multivariable adjustment nonagenarians had no significantly increased risk for 30-day-mortality (aOR 1.25 (95% CI 0.90-1.74; p = 0.19)). Conclusion: After adjustment for confounders, nonagenarians demonstrated no higher 30-day mortality than octogenarian patients. In this study, being age 90 years or more is no particular risk factor for an adverse outcome. This should be considered- together with illness severity and pre-existing functional capacity - to effectively guide triage decisions.

Published
2021

146. The impact of frailty on survival in elderly intensive care patients with COVID-19: the COVIP study

Author

Jung, Christian, Flaatten, Hans, Fjølner, Jesper, Bruno, Raphael Romano, Wernly, Bernhard, Artigas, Antonio, Bollen Pinto, Bernardo, Schefold, Joerg, Wolff, Georg, Kelm, Malte, Beil, Michael, Sviri, Sigal, van Heerden, Peter Vernon, Szczeklik, Wojciech, Czuczwar, Miroslaw, Elhadi, Muhammed, Joannidis, Michael, Oeyen, Sandra, Zafeiridis, Tilemachos, Marsh, Brian, Andersen, Finn, Moreno, Rui, Cecconi, Maurizio, Leaver, Susannah, Boumendil, Ariane, de Lange, Dylan, Guidet, Bertrand, Abosheaishaa, Hazem Maarouf, Abualqumboz, Enas, Ahmed, Abdullah Khudhur, Ahmed, Hazem, Aidoni, Zoi, Aldecoa, Cesar, Alexandru, Nica, Ali, Yasmin Khairy Nasreldin Mohamed, Al-Sadawi, Mohammed, Andersen, Kasper, Assis, Rui, Azab, Mohammed, Azzam, Ahmed, Badawy, Mohamed Raafat, Balleby, Ida Riise, Barth, Eberhard, Ben-Hamouda, Nawfel, Besch, Guillaume, Besset, Sebastien, Bjerregaard, Anders Thais, Brix, Helene, Brushoej, Jens, Bundgaard, Helle, Burtin, Philippe, Caillard, Anais, Canas-Perez, Isabel, Charron, Cyril, Chrisanthopoulou, Evangelia, Comellini, Vittoria, Cornet, Alex, Cubero, Patricia Jimeno, Dauger, Stéphane, Diaz-Rodriguez, Cristina, Dieperink, Willem, Dindane, Zouhir, Djibré, Michel, Dormans, Tom, Dullenkopf, Alexander, Dumas, Guillaume, Elgazzar, Yumna, Eller, Philipp, Elsaka, Ahmed, Evers, Mirjam, Faltlhauser, Andreas, Ferreira, Aida Fernández, Fleury, Yvan, Galbois, Arnaud, Garcon, Pierre, Garnier, Marc, Gawda, Ryszard, Ghannam, Abdelilah, Goebel, Ulrich, Gomà, Gemma, Goncalves, Bruno, Gordinho, André, Groenendijk, Martijn, Guerot, Emmanuel, Gurjar, Mohan, Haake, Hendrik, Haas, Lenneke, Habib, Ayman Abdelmawgoad, Hahn, Michael, Hansen, Maria Aagaard, Hilles, Momin Majed Yousuf, Hussein, Aliae, Iglesias, David, Jurcisin, Igor, Kabitz, Hans-Joachim, Kindgen-Milles, Detlef, Klimkiewicz, Jakub, Kuhn, Karl Friedrich, Kunstein, Anselm, Kurt, Muhammed, Lutz, Matthias, Mahmoodpoor, Ata, Maizel, Julien, Marin, Nathalie, Megarbane, Buno, Mesotten, Dieter, Meybohm, Patrick, Meyer, Christian, Mira, Angela Prado, Namendys-Silva, Silvio, Nedergaard, Helene Korvenius, Nseir, Saad, Olasveengen, Theresa, Oliveira, Ana Isabel Pinho, Oziel, Johanna, Papadogoulas, Antonios, Perez-Torres, David, Piton, Gaël, Plantefeve, Gaëtan, Poerner, Tudor, Priego, Jesús, Rabha, Ahmed, Randerath, Winfried, Raphaelen, Jean-Herlé, Reper, Pascal, Rigaud, Jean-Philippe, Rivera, Susana Arias, Roberti, Andrea, Romundstad, Luis, Rovina, Nikoletta, Salah, Rehab, Saleh, Mahmoud, Sancho, Susana, de Lurdes Campos Santos, Maria, Santos, Henrique, Schaller, Stefan, Schuster, Michael, Shala, Gonxhe, Sjøbø, Britt, Steiner, Stephan, Strietzel, Hans Frank, Swinnen, Walter, Tamayo-Lomas, Luis, Tharwat, Samar, Tomasa, Teresa, Uhrenholt, Stine, Vaissiere, Marie, Valent, Arnaud, Valette, Xavier, Vanderlinden, Thierry, Vázquez, Eric Mayor, Villamayor, Mercedes Ibarz, Villefrance, Maja, Voigt, Ingo, Wassim, Kyrillos, Welte, Martin, Wollborn, Jakob, Zalba-Etayo, Begoña, Zegers, Marieke, Mégarbane, Bruno, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, Service de Réanimation Médicale et Toxicologique [Hôpital Lariboisière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Optimisation thérapeutique en Neuropsychopharmacologie (OPTeN (UMR_S_1144 / U1144)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), and COVIP study group

Subjects
[SDV.TOX] Life Sciences [q-bio]/Toxicology, [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [SDV.TOX]Life Sciences [q-bio]/Toxicology, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
Abstract

Auteurs : COVIP study group; International audience; Background The COVID-19 pandemic has led highly developed healthcare systems to the brink of collapse due to the large numbers of patients being admitted into hospitals. One of the potential prognostic indicators in patients with COVID-19 is frailty. The degree of frailty could be used to assist both the triage into intensive care, and decisions regarding treatment limitations. Our study sought to determine the interaction of frailty and age in elderly COVID-19 ICU patients. Methods A prospective multicentre study of COVID-19 patients ≥ 70 years admitted to intensive care in 138 ICUs from 28 countries was conducted. The primary endpoint was 30-day mortality. Frailty was assessed using the clinical frailty scale. Additionally, comorbidities, management strategies and treatment limitations were recorded. Results The study included 1346 patients (28% female) with a median age of 75 years (IQR 72–78, range 70–96), 16.3% were older than 80 years, and 21% of the patients were frail. The overall survival at 30 days was 59% (95% CI 56–62), with 66% (63–69) in fit, 53% (47–61) in vulnerable and 41% (35–47) in frail patients ( p

Published
2021
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147. Frühmobilisation auf der Intensivstation – Sind robotergestützte Systeme die Zukunft?

Author

Huebner, Lucas, Schroeder, Ines, Kraft, Eduard, Gutmann, Marcus, Biebl, Johanna, Klamt, Amrei Christin, Frey, Jana, Warmbein, Angelika, Rathgeber, Ivanka, Eberl, Inge, Fischer, Uli, Scharf, Christina, Schaller, Stefan J., and Zoller, Michael

Subjects
MUSCLE weakness, CRITICALLY ill, POLYNEUROPATHIES, CRITICAL care medicine, REHABILITATION
Abstract

Copyright of Anaesthesist is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2022
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148. Attenuating Muscle Mass Loss in Critical Illness: the Role of Nutrition and Exercise.

Author

Chapple, Lee-anne S., Parry, Selina M., and Schaller, Stefan J.

Abstract

Purpose of Review: Impaired recovery following an intensive care unit (ICU) admission is thought related to muscle wasting. Nutrition and physical activity are considered potential avenues to attenuate muscle wasting. The aim of this review was to present evidence for these interventions in attenuating muscle loss or improving strength and function. Recent Findings: Randomised controlled trials on the impact of nutrition or physical activity interventions in critically ill adult patients on muscle mass, strength or function are presented. No nutrition intervention has shown an effect on strength or function, and the effect on muscle mass is conflicting. RCTs on the effect of physical activity demonstrate conflicting results; yet, there is a signal for improved strength and function with higher levels of physical activity, particularly when commenced early. Summary: Further research is needed to elucidate the impact of nutrition and physical activity on muscle mass, strength and function, particularly in combination. [ABSTRACT FROM AUTHOR]

Published
2022
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149. Erfassung und apparatives Monitoring des Ernährungsstatus von Patient*innen auf der Intensiv- und Intermediate Care Station: Positionspapier der Sektion Metabolismus und Ernährung der Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin (DIVI)

Author

Weimann, Arved, Hartl, Wolfgang H., Adolph, Michael, Angstwurm, Matthias, Brunkhorst, Frank M., Edel, Andreas, de Heer, Geraldine, Felbinger, Thomas W., Goeters, Christiane, Hill, Aileen, Kreymann, K. Georg, Mayer, Konstantin, Ockenga, Johann, Petros, Sirak, Rümelin, Andreas, Schaller, Stefan J., Schneider, Andrea, Stoppe, Christian, and Elke, Gunnar

Subjects
NUTRITIONAL assessment, INTENSIVE care patients, INTENSIVE care units, DIET therapy, CRITICAL care medicine
Abstract

Copyright of Medizinische Klinik: Intensivmedizin & Notfallmedizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2022
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150. „Intensive Care Unit-Acquired Weakness": Eine bundesweite Umfrage zu Diagnostik, Monitoring und Therapiestrategien auf deutschen Intensivstationen.

Author

Klawitter, Felix, Schaller, Stefan J., Söhle, Martin, Reuter, Daniel A., and Ehler, Johannes

Subjects
*CRITICALLY ill, *POLYNEUROPATHIES, *MUSCLE diseases, *QUESTIONNAIRES
Abstract

Background: Intensive care unit-acquired weakness (ICU-AW) is one of the most frequent causes of neuromuscular dysfunction in intensive care medicine. To date no evidence-based recommendations exist for the diagnostics, monitoring or further intensive care treatment. Objective: To evaluate the current clinical practice of diagnostics, monitoring and treatment strategies of ICU-AW on intensive care units in Germany. Material and methods: We conducted an online survey with a self-designed questionnaire and invited 448 members of the Scientific Working Group for Intensive Care Medicine (WAKI) and the Scientific Working Group for Neuroanesthesia (WAKNA) to participate. Results: A total of 68/448 (15.2%) questionnaires were analyzed. Of the participants 13.4% (9/67) stated that a structured diagnostic approach for the detection of ICU-AW is applied in their units. The clinical examination was the preferred method for screening (60/68; 88.2%) and follow-up (57/65; 87.7%). Scores, such as the Medical Research Council sum score (MRC-SS) seem to be less important for the screening (7/68; 10.3%) and follow-up assessment (7/65; 10.8%). Mobilization with physiotherapy (45/68; 66.2%) is the most common strategy applied to treat ICU-AW. A lack of physiotherapists (64/68; 94.1%) and intensive care nurses (57/68; 83.8%) are the main deficits identified in the care of patients with ICU-AW. The majority of the study participants (62/68; 91.2%) would welcome evidence-based guidelines for diagnostics, monitoring and treatment approaches in ICU-AW. Discussion: To date comprehensive recommendations for diagnostics, monitoring, prevention and treatment of ICU-AW are still lacking in German intensive care units. The introduction of new diagnostic approaches could help to detect ICU-AW and therefore to initiate earlier preventive and treatment approaches. [ABSTRACT FROM AUTHOR]

Published
2022
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