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3. Alpha-1 antitrypsin inhibits pertussis toxin

Author

Lietz, Stefanie, Sommer, Anja, Sokolowski, Lena-Marie, Kling, Carolin, Rodríguez Alfonso, Armando A., Preising, Nico, Alpízar-Pedraza, Daniel, King, Jaylyn, Streit, Lisa, Schröppel, Bernd, van Erp, Rene, Barth, Eberhard, Schneider, Marion, Münch, Jan, Michaelis, Jens, Ständker, Ludger, Wiese, Sebastian, Barth, Holger, Pulliainen, Arto T., Scanlon, Karen, and Ernst, Katharina

Published
2024
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6. Inhaled isoflurane via the anaesthetic conserving device versus propofol for sedation of invasively ventilated patients in intensive care units in Germany and Slovenia: an open-label, phase 3, randomised controlled, non-inferiority trial

Author

Barth, Eberhard, Becher, Tobias, Bein, Berthold, Bellgardt, Martin, Biever, Paul, Bogdanski, Ralph, Bracht, Hendrik, Brandt, Sebastian, Drüner, Matthias, Faltlhauser, Anreas, Geise, Arnim, Georgevici, Adrian Iustin, Gude, Philipp, Guenther, Ulf, Hamsen, Uwe, Hönemann, Christian, Kellner, Patrick, Kellner, Kerstin, Kermad, Azzeddine, Knafelj, Rihard, Kogelmann, Klaus, Kram, Rainer, Markota, Andrej, Meermeier, Werner, Meiser, Andreas, Podbregar, Matej, Sackey, Peter, Schramm, Patrick, Schroeder, Matthias, Schwarzkopf, Konrad, Soukup, Jens, Thal, Serge C, Vogelsang, Heike, Volk, Thomas, Wallenborn, Jan, Waydhas, Christian, Weiler, Norbert, Wetzold, Richard, and Faltlhauser, Andreas

Published
2021
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7. Therapy limitation in octogenarians in German intensive care units is associated with a longer length of stay and increased 30 days mortality: A prospective multicenter study

Author

Bruno, Raphael Romano, Wernly, Bernhard, Beil, Michael, Muessig, Johanna M., Rahmel, Tim, Graf, Tobias, Meybohm, Patrick, Schaller, Stefan J., Allgäuer, Sebastian, Franz, Marcus, Westphal, Julian Georg, Barth, Eberhard, Ebelt, Henning, Fuest, Kristina, Horacek, Michael, Schuster, Michael, Dubler, Simon, Schering, Stefan, Wolff, Georg, Steiner, Stephan, Rabe, Christian, Dieck, Thorben, Lauten, Alexander, Sacher, Anne Lena, Brenner, Thorsten, Bloos, Frank, Jánosi, Rolf A., Simon, Philipp, Utzolino, Stefan, Kelm, Malte, De Lange, Dylan W., Guidet, Bertrand, Flaatten, Hans, and Jung, Christian

Published
2020
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16. Correction to: Incidence of severe sepsis and septic shock in German intensive care units: the prospective, multicentre INSEP study

Author

Marx, Gernot, Litmathe, Jens, Schulz, Jörg B., Dafotakis, Manuel, Möllhoff, Thomas, Stalljohann, Carolin, Engels, Jonas, Sauerzapfe, Barbara, Stolzenberg, Barbara, Jonas, Engels, Möllhoff, Thomas, Carolin, Stalljohann, Thorben, Beeker, Gernot, Marx, Melanie, Schäfer, Tobias, Schürholz, Ertunc, Altiok, Marx, Nikolaus, Alexander, Kersten, Hannah, Dückers, Alexander, Koch, Trautwein, Christian, Scharf, Alexander, Kreuzer, Ilse, Jaschinski, Ulrich, Kreuzer, Ilse, Jaschinski, Ulrich, Niklas, Markus, Kulzer, Michael, Schlott, Martin, Iberer, Thomas, Stella, Oelert, Thorsten, Löhr, Vandana, Pillai, Praeger, Damaris, Knebel, Fabian, Baumann, Gert, Rosseau, Simone, Schlenk, Florian, Hoffmeister, Bodo, Compton, Friederike, Hoffmann, Clemens, Rademacher, Sibylle, Vietzke, Michael, Jörres, Achim, Meisel, Andreas, Hotter, Benjamin, Mengel, Annerose, Goldmann, Anton, Nöther, Frank, Keh, Didier, Schmidt, Katrin, Angermair, Stefan, Kaffarnik, Magnus, Bubser, Florian, Gummelt, Immo, Vedder, Ina, Bach, Friedhelm, Winter, Markus, Weißer, Frank, Roederer, Marc, Martini, Stefan, Bergmann, Lars, Adamzik, Michael, Baumann, Andreas, Wolf, Britta, Zahn, Peter K., Lehnhardt, Marcus, Daigeler, Adrien, Andreas, Andreas Hohn, Reinhold, Katrin, Adolf, Michael, Altenbeck, Nicole, Gussone, Christoph, Dietrich, Johannes Wolfgang, Köditz, Roland, Putensen, Christian, Schewe, Jens-Christian, Muders, Thomas, Soukup, Jens, Skitek, Kornel, Geisser, Wolfgang, Alber, Andreas, Düthorn, Ludwig, Demund, Josef, Düthorn, Ludwig, Criegern, Isabel v., Nowak, Andreas, Morgenstern, Toralf, Gliniorz, Christoph, Meisner, Michael, Dexel, Melanie, Schütte, Jan Karl, Huppertz-Thyssen, Markus H., Schröder, Stefan, Kowalzik, Ralf, Guel, Cansu, Terhorst, Rainer, Nießen, Peter, Hauschild, Rolf, Mutzek, Elisabeth-Maria, Kogelmann, Klaus, Drüner, Matthias, Jarczak, Dominik, Forster, Christian, Willam, Carsten, Eckardt, K. U., Clemenz, Rüdiger, Siemonsen, Sven, Pauschinger, Matthias, Baumgärtel, Matthias, Muschner, Dorothea, Christ, Michael, Wenzl, Martin, Höhl, Rainer, Junger, Axel, Wöhrle, Armin, Kanthak, Henry, Leschke, Matthias, Kanthak, Henry, Wöhrle, Armin, Leschke, Matthias, Kessler, Paul, Souquet, Jochen, Holfeld, Andreas, Habler, Oliver, Thörner, Markus, Vogt, Oliver, Meybohm, Patrick, Zacharowski, Kai, Lindau, Simone, Lenk, Marcus, Weis, Florian, Schubert, Hermann, Kemnitz, Jürgen, Reckort, Sven, Weikert, Martina, Sudhues, Ulrich, Möller, Stefan, Stefan, Pinger, Domke, Andrea, Wiesenack, Christoph, Schmidt, Florian, Döbel, Kai-Uwe, Moerer, Onnen, Schäper, Jörn, Kernchen, Andrea, Gründling, Matthias, Bollmann, Jan, Kuhn, Sven-Olaf, Kemming, Gregor, Einfeld, Carsten, Sommerer, Thomas, Kemming, Gregor, Einfeld, Carsten, Sommerer, Thomas, Köntges, Philipp, Hinz, Burkhard, Jauch, Lars-Oliver, Selonke, Lutz, Kluge, Stefan, Nierhaus, Axel, de Heer, Geraldine, Gruß, Marco, Köhler, Katja, Brinkmann, Alexander, Fuchs, Thomas, Köberer, Andreas, Geuting, Markus, Weigt, Henry, Baltus, Thomas, Scheltz, Claudia, Bloos, Frank, Reinhart, Konrad, Jegen, Rudolf, Flucht, Marcus, Jürgen, Gburek, Flucht, Marcus, Jegen, Rudolf, Stumm, Anne, Rossenbach, Jannik, Stumm, Anne, Haller, Mathias, Stumm, Anne, Rossenbach, Jannik, Lynch, John, Kempkens, Martin, Buechner, Volkmar, Molitor, Dieter, Klasen, Gerda, Rahmen, Bruno, Muhr, Petra, Canaviri, Patricia, Fiedler, Fritz, Lutz, Jürgen, Kaiser, Marc, Klünter, Simon, Krep, Henning, Anders, Helge, Aduckathil, Sanjay, Sakka, Samir, Reessing, Jan Hinnerk, Aabaid, Sabrina, Löbe, Mathias, Bogatsch, Holger, Löffler, Marcus, Engels, Christoph, Molter, Gerd Peter, Stunz, Michael, Mitrenga, Anja, Geldner, Götz, Bürle, Monica, Klasen, Robert, Werner, Steffanie, Wilhelm, Wolfram, Silke, Frenzel, Juliane, Illert, Jana, Schuttpelz, Briegel, Josef, Möhnle, Patrick, Knorr, Adrian, Hartl, Wolfgang, Ney, Ludwig, Stemmler, Hans-Joachim, Pfister, Hans-Walter, Angstwurm, Matthias, Frey, Lorenz, Irlbeck, Michael, Huge, Volker, Weis, Marion, Kilger, Erich, Hofmann-Kiefer, Klaus, Felbinger, Thomas, Kaufmann, Ines, Goeschl, Julia, Brettner, Franz, Hamm, Heiner, Eife, Claudia, Peckelsen, Claus, Findeisen, Michael, Schmidt-Schridde, Patrick, Kuner, Andreas, Walz, Thomas, Kuner, Barbara, Schrauzer, Thomas, Nentwich, Jens, John, Stefan, Byhahn, Christian, Kretschmer, Thomas, Bergold, Martin N., Weyland, Andreas, Jelschen, Florian, Diers, Anja, Knebel, Frieder G., Kupfer, Thomas, Oppert, Michael, Rohde, Steffen, Möllemann, Angela, Oehmichen, Uwe, Renner, Theresa, Bone, Hans-Georg, Freyhoff, Jörg, Holst, Dana, Birken, Thomas, Henschel, Jörg, Gloger, Martin, Brock, Peter, Klösel, Stephan, Albuszies, Gerd, Schumacher, Detlef, Meierhenrich, Rainer, Schöpp, Alexej, Kuhn, Harald, Riessen, Reimer, Haap, Michael, Ziegler, Silvia, Fastnacht-Böttcher, Jana, Schröder, Rolf Jürgen, Weiss, Manfred, Frank, Katrin, Georgieff, Michael, Weiss, Manfred, Barth, Eberhard, Bracht, Henrik, Ehmcke, Heidrun, Francke, Astrid, Ott, Stefan, Köpcke, Jens, Meyer, Andreas, Jokiel, Gunnar, Freund, Thomas, Schick, Guido, Karassimos, Evagelos, and SepNet Critical Care Trials Group

Published
2017
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19. 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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20. 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.

Published
2022
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22. 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

Published
2022
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23. 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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25. Inhaled isoflurane via the anaesthetic conserving device versus propofol for sedation of invasively ventilated patients in intensive care units in Germany and Slovenia: an open-label, phase 3, randomised controlled, non-inferiority trial

Author

Meiser, Andreas, primary, Volk, Thomas, additional, Wallenborn, Jan, additional, Guenther, Ulf, additional, Becher, Tobias, additional, Bracht, Hendrik, additional, Schwarzkopf, Konrad, additional, Knafelj, Rihard, additional, Faltlhauser, Andreas, additional, Thal, Serge C, additional, Soukup, Jens, additional, Kellner, Patrick, additional, Drüner, Matthias, additional, Vogelsang, Heike, additional, Bellgardt, Martin, additional, Sackey, Peter, additional, Barth, Eberhard, additional, Bein, Berthold, additional, Biever, Paul, additional, Bogdanski, Ralph, additional, Brandt, Sebastian, additional, Faltlhauser, Anreas, additional, Geise, Arnim, additional, Georgevici, Adrian Iustin, additional, Gude, Philipp, additional, Hamsen, Uwe, additional, Hönemann, Christian, additional, Kellner, Kerstin, additional, Kermad, Azzeddine, additional, Kogelmann, Klaus, additional, Kram, Rainer, additional, Markota, Andrej, additional, Meermeier, Werner, additional, Meiser, Andreas, additional, Podbregar, Matej, additional, Schramm, Patrick, additional, Schroeder, Matthias, additional, Waydhas, Christian, additional, Weiler, Norbert, additional, and Wetzold, Richard, additional

Published
2021
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26. 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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28. 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

30. 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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32. Lactate is associated with mortality in very old intensive care patients suffering from COVID-19: results from an international observational study of 2860 patients

Author

Bruno, Raphael Romano, Wernly, Bernhard, Flaatten, Hans, Artigas, Antonio, Bollen Pinto, Bernardo, Binnebössel, Stephan, Baldia, Philipp Heinrich, Kelm, Malte, Beil, Michael, Sigal, Sivri, van Heerden, Peter Vernon, Elhadi, Muhammed, Zafeiridis, Tilemachos, Arche Banzo, Maria José, Moreno, Rui, Boumendil, Ariane, De Lange, Dylan W., Eller, Philipp, Joannidis, Michael, Mesotten, Dieter, Reper, Pascal, Oeyen, Sandra, Swinnen, Walter, Serck, Nicolas, Dewaele, Elisabeth, Chapeta, Edwin, Brix, Helene, Brushoej, Jens, Kumar, Pritpal, Nedergaard, Helene Korvenius, Johnsen, Tim Koch, Bundesen, Camilla, Hansen, Maria Aagaard, Uhrenholt, Stine, Bundgaard, Helle, Fjølner, Jesper, Innes, Richard, Gooch, James, Cagova, Lenka, Potter, Elizabeth, Reay, Michael, Davey, Miriam, Abusayed, Mohammed Abdelshafy, Humphreys, Sally, Collins, Amy, Aujayeb, Avinash, Leaver, Susannah, Khaliq, Waqas, Habib, Ayman Abdelmawgoad, Azab, Mohammed A., Wassim, Kyrillos, Elgazzar, Yumna A., Salah, Rehab, Abosheaishaa, Hazem Maarouf, Hussein Mohamed, Aliae A. R., Azzam, Ahmed Y., Tharwat, Samar, Ali, Yasmin Khairy Nasreldin Mohamed, Elmandouh, Omar, Galal, Islam, Abu-Elfatth, Ahmed, Motawea, Karam, Elbahnasawy, Mohammad, Shehata, Mostafa, Elbahnasawy, Mohamed, Tayeb, Mostafa, Osman, Nermin, Abdel-Elsalam, Wafaa, Hussein, Aliae Mohamed, Aldhalia, Amer, Galbois, Arnaud, Guidet, Bertrand, 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, Mentec, Hervé, 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, Barth, Eberhard, Poerner, Tudor, Simon, Philipp, Lorenz, Marco, Dindane, Zouhir, Kuhn, Karl Friedrich, Welte, Martin, Voigt, Ingo, Kabitz, Hans-Joachim, Wollborn, Jakob, Goebel, Ulrich, Stoll, Sandra Emily, Kindgen-Milles, Detlef, Dubler, Simon, Jung, Christian, Fuest, Kristina, Schuster, Michael, Steiner, Stephan, Papadogoulas, Antonios, Mulita, Francesk, Rovina, Nikoletta, Aidoni, Zoi, Chrisanthopoulou, Evangelia, Kondili, Eumorfia, Andrianopoulos, Ioannis, Gurjar, Mohan, Mahmoodpoor, Ata, Hussein, Rand, Al-Juaifari, Maytham Aqeel, Karantenachy, Abdullah Khudhur Ahmed, Sviri, Sigal, Elsaka, Ahmed, Marsh, Brian, Comellini, Vittoria, Al-Ali, Farah, Almani, Sari, Khamees, Almu' Atasim, Al-Shami, Khayry, El Din, Ibrahim Salah, Abubaker, Taha, Ahmed, Hazem, Rabha, Ahmed, Emhamed, Marwa, Abdeewi, Saedah, Abusalama, Abdurraouf, Alhadi, Abdulmueti, Huwaysh, Mohammed, Alghati, Esraa Abdalqader, Ghannam, Abdelilah, Namendys-Sylva, Silvio A., Groenendijk, Martijn, Evers, Mirjam, Van Lelyveld-Haas, Lenneke, Meynaar, Iwan, Cornet, Alexander Daniel, Zegers, Marieke, Dieperink, Willem, De Lange, Dylan, Dormans, Tom, Hahn, Michael, Sjøbøe, Britt, Strietzel, Hans Frank, Olasveengen, Theresa, Romundstad, Luis, Andersen, Finn H., Massoud, John George Grace, Khan, Aamir Ghafoor, Al-Qasrawi, Shahd, Amro, Sarah, Kluzik, Anna, Zatorski, Pawel, Drygalski, Tomasz, Szczeklik, Wojciech, 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, Grintescu, Ioana Marina, Tomescu, Dana, Badawy, Mohamed Raafat, José Arche Banzo, M., Zalba-Etayo, Begoña, Cubero, Patricia Jimeno, 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, Saleh, Mahmoud, Hilles, Momin Majed Yousuf, Abualqumboz, Enas M. Y., Ben-Hamouda, Nawfel, Roberti, Andrea, Fleury, Yvan, Abidi, Nour, Schefold, Joerg C., Chau, Ivan, Dullenkopf, Alexander, Chaaban, Mohammad Karam, Shebani, Mohammed Mouaz, Hmaideh, Ahmad, Shaher, Aymen, Sahin, Ayca Sultan, Saracoglu, Kemal Tolga, Al-Sadawi, Mohammed, Pugh, Richard, Smuts, Sara, and Al-Saban, Rafat Ameen Mohammed

Subjects
Research, Intensive / Critical Care Medicine, Emergency Medicine, Anesthesiology, ddc
Published
2020

33. Animal-Free human whole blood sepsis model to study changes in innate immunity

Author

Messerer, David Alexander Christian, Vidoni, Laura, Erber, Maike, Stratmann, Alexander Elias Paul, Bauer, Jonas Martin, Braun, Christian Karl, Hug, Stefan, Adler, Anna, Nilsson Ekdahl, Kristina, Nilsson, Bo, Barth, Eberhard, Radermacher, Peter, and Huber-Lang, Markus

Subjects
Inflammation, Lipopolysaccharides, neutrophil dysfunction, Blood physiological phenomena, blood physiology, Neutrophils, Entzündung, Immunology, Immunology in the medical area, Shock, Septic, neutrophil granulocytes, Phagocytosis, principles of the 3Rs, Immunologi inom det medicinska området, Sepsis, Immunologi, ex vivo whole blood model, Immunology and Allergy, ddc:610, oxidative burst, Neutrophiler Granulozyt, DDC 610 / Medicine & health, Receptor, Anaphylatoxin C5a, lipopolysaccharide (LPS), Granulocytes
Abstract

Studying innate immunity in humans is crucial for understanding its role in the pathophysiology of systemic inflammation, particularly in the complex setting of sepsis. Therefore, we standardized a step-by-step process from the venipuncture to the transfer in a human model system, while closely monitoring the inflammatory response for up to three hours. We designed an animal-free, human whole blood sepsis model using a commercially available, simple to use, tubing system. First, we analyzed routine clinical parameters, including cell count and blood gas analysis. Second, we demonstrated that extracellular activation markers (e.g., CD11b and CD62l) as well as intracellular metabolic (intracellular pH) and functional (generation of radical oxygen species) features remained stable after incubation in the whole blood model. Third, we mimicked systemic inflammation during early sepsis by exposure of whole blood to pathogen-associated molecular patterns. Stimulation with lipopolysaccharide revealed the capability of the model system to evoke a sepsis-like inflammatory phenotype of innate immunity. In summary, the presented model serves as a convenient, economic, and reliable platform to study innate immunity in human whole blood, which may yield clinically important insights., publishedVersion

Published
2020

39. Animal-Free Human Whole Blood Sepsis Model to Study Changes in Innate Immunity

Author

Messerer, David Alexander Christian, primary, Vidoni, Laura, additional, Erber, Maike, additional, Stratmann, Alexander Elias Paul, additional, Bauer, Jonas Martin, additional, Braun, Christian Karl, additional, Hug, Stefan, additional, Adler, Anna, additional, Nilsson Ekdahl, Kristina, additional, Nilsson, Bo, additional, Barth, Eberhard, additional, Radermacher, Peter, additional, and Huber-Lang, Markus, additional

Published
2020
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40. Therapy limitation in octogenarians in German intensive care units is associated with a longer length of stay and increased 30 days mortality: A prospective multicenter study

Author

Medische Staf Intensive Care, NVIC bedrijfsvoering, Brain, Infection & Immunity, Bruno, Raphael Romano, Wernly, Bernhard, Beil, Michael, Muessig, Johanna M, Rahmel, Tim, Graf, Tobias, Meybohm, Patrick, Schaller, Stefan J, Allgäuer, Sebastian, Franz, Marcus, Westphal, Julian Georg, Barth, Eberhard, Ebelt, Henning, Fuest, Kristina, Horacek, Michael, Schuster, Michael, Dubler, Simon, Schering, Stefan, Wolff, Georg, Steiner, Stephan, Rabe, Christian, Dieck, Thorben, Lauten, Alexander, Sacher, Anne Lena, Brenner, Thorsten, Bloos, Frank, Jánosi, Rolf A, Simon, Philipp, Utzolino, Stefan, Kelm, Malte, De Lange, Dylan W, Guidet, Bertrand, Flaatten, Hans, Jung, Christian, Medische Staf Intensive Care, NVIC bedrijfsvoering, Brain, Infection & Immunity, Bruno, Raphael Romano, Wernly, Bernhard, Beil, Michael, Muessig, Johanna M, Rahmel, Tim, Graf, Tobias, Meybohm, Patrick, Schaller, Stefan J, Allgäuer, Sebastian, Franz, Marcus, Westphal, Julian Georg, Barth, Eberhard, Ebelt, Henning, Fuest, Kristina, Horacek, Michael, Schuster, Michael, Dubler, Simon, Schering, Stefan, Wolff, Georg, Steiner, Stephan, Rabe, Christian, Dieck, Thorben, Lauten, Alexander, Sacher, Anne Lena, Brenner, Thorsten, Bloos, Frank, Jánosi, Rolf A, Simon, Philipp, Utzolino, Stefan, Kelm, Malte, De Lange, Dylan W, Guidet, Bertrand, Flaatten, Hans, and Jung, Christian

Published
2020

41. Functional immune monitoring in severely injured patients—A pilot study

Author

Halbgebauer, Rebecca, primary, Kellermann, Stephanie, additional, Schäfer, Fabian, additional, Weckbach, Sebastian, additional, Weiss, Manfred, additional, Barth, Eberhard, additional, Bracht, Hendrik, additional, Kalbitz, Miriam, additional, Gebhard, Florian, additional, Huber‐Lang, Markus S., additional, and Perl, Mario, additional

Published
2019
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43. A comparison of very old patients admitted to intensive care unit after acute versus elective surgery or intervention

Author

Jung, Christian, Wernly, Bernhard, Muessig, Johanna M., Kelm, Malte, Boumendil, Ariane, Morandi, Alessandro, Andersen, Finn H., Artigas, Antonio, Bertolini, Guido, Cecconi, Maurizio, Christensen, Steffen, Faraldi, Loredana, Fjolner, Jesper, Lichtenauer, Michael, Bruno, Raphael Romano, Marsh, Brian, Moreno, Rui, Oeyen, Sandra, Ohman, Christina Agvald, Pinto, Bernadro Bollen, Soliman, Ivo W., Szczeklik, Wojciech, Valentin, Andreas, Watson, Ximena, Zafeiridis, Tilemachos, De Lange, Dylan W., Guidet, Bertrand, Flaatten, Hans, Schmutz, Rene, Wimmer, Franz, Eller, Philipp, Joannidis, Michael, De Buysscher, Pieter, De Neve, Nikolaas, Swinnen, Walter, Abraham, Paul, Hergafi, Leila, Schefold, Joerg C., Biskup, Ewelina, Piza, Petr, Taliadoros, Ioannis, Dey, Nilanjan, Solling, Christoffer, Rasmussen, Bodil Steen, 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, 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, Aidoni, Zoi, Aloizos, Stavros, Tasioudis, Polychronis, Lampiri, Kleri, Zisopoulou, Vasiliki, Ravani, Ifigenia, Pagaki, Eumorfia, Antoniou, Angela, Katsoulas, Theodoros A., Kounougeri, Aikaterini, Marinakis, George, Tsimpoukas, Fotios, Spyropoulou, Anastasia, Zygoulis, Paris, Kyparissi, Aikaterini, Gupta, Manish, Gurjar, Mohan, Maji, Ismail M., Hayes, Ivan, Kelly, Yvelynne, Westbrook, Andrew, Fitzpatrick, Gerry, Maheshwari, Darshana, Motherway, Catherine, Negri, Giovanni, Spadaro, Savino, Nattino, Giuseppe, Pedeferri, Matteo, Boscolo, Annalisa, Rossi, Simona, 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, Adorni, Adele, Bocci, Maria Grazia, Cortegiani, Andrea, Casalicchio, Tiziana, Mellea, Serena, Graziani, Elia, Barattini, Massimo, Brizio, Elisabetta, Rossi, Maurizio, Hahn, Michael, Kemmerer, Nicolai, Strietzel, Hans Frank, Dybwik, Knut, Legernaes, Terje, Klepstad, Pal, Olaussen, Even Braut, Olsen, Knut Inge, Brresen, Ole Marius, Bjorsvik, Geir, Maini, Sameer, Fehrle, Lutz, Czuczwar, Miroslaw, Krawczyk, Pawel, Zietkiewicz, Miroslaw, Nowak, Lukasz R., Kotfis, Katarzyna, Cwyl, Katarzyna, Gajdosz, Ryszard, Biernawska, Jowita, Bohatyrewicz, Romuald, Gawda, Ryszard, Grudzien, Pawel, Nasilowski, Pawel, Popek, Natalia, Cyrankiewicz, Waldemar, Wawrzyniak, Katarzyna, Wnuk, Marek, Maciejewski, Dariusz, Studzinska, Dorota, Zukowski, Maciej, Bernas, Szymon, Piechota, Mariusz, Nowak, Ilona, Fronczek, Jakub, Serwa, Marta, Machala, Waldemar, Stefaniak, Jan, Wujtewicz, Maria, Maciejewski, Pawel, Szymkowiak, Malgorzata, Adamik, Barbara, Catorze, Nuno, Branco, Miguel Castelo, Barros, Ines, 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, Rodriguez, Enver, Rebollo, Sergio, Aguilar, Gerardo, Masdeu, Gaspar, Irazabal Jaimes, Marian, Prado Mira, Angela, Bodi, Maria A., Barea Mendoza, Jesus A., Lopez-Cuenca, Sonia, Homez Guzman, Marcela, Rico-Feijoo, Jesus, Ibarz, Mercedes, Trenado Alvarez, Josep, Kawati, Rafael, Sivik, Joakim, Nauska, Jessica, Smole, Daniel, Parenmark, Fredric, Lyren, Johanna, Rockstroh, Katalin, Ryden, Sara, Spangfors, Martin, Strinnholm, Morten, Walther, Sten, De Geer, Lina, Nordlund, Peter, Palsson, Staffan, Zetterquist, Harald, Nilsson, Annika, Thiringer, Karin, Jungner, Marten, Bark, Bjorn, Nordling, Berit, Skold, Hans, Brorsson, Camilla, Persson, Stefan, Bergstrom, Anna, Berkius, Johan, Holmstrom, Johanna, van Dijk, I, van Lelyveld-Haas, L. E. M., Ramnarain, D., Jansen, Tim, Nooteboom, Fleur, van der Voort, Peter H. J., de Lange, Dylan, Dieperink, Willem, de Waard, Monique C., de Smet, Annemarie G. E., Bormans, Laura, Dormans, Tom, 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, 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, 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, Nalapko, Yuiry, Jung, Christian, Wernly, Bernhard, Muessig, Johanna M., Kelm, Malte, Boumendil, Ariane, Morandi, Alessandro, Andersen, Finn H., Artigas, Antonio, Bertolini, Guido, Cecconi, Maurizio, Christensen, Steffen, Faraldi, Loredana, Fjolner, Jesper, Lichtenauer, Michael, Bruno, Raphael Romano, Marsh, Brian, Moreno, Rui, Oeyen, Sandra, Ohman, Christina Agvald, Pinto, Bernadro Bollen, Soliman, Ivo W., Szczeklik, Wojciech, Valentin, Andreas, Watson, Ximena, Zafeiridis, Tilemachos, De Lange, Dylan W., Guidet, Bertrand, Flaatten, Hans, Schmutz, Rene, Wimmer, Franz, Eller, Philipp, Joannidis, Michael, De Buysscher, Pieter, De Neve, Nikolaas, Swinnen, Walter, Abraham, Paul, Hergafi, Leila, Schefold, Joerg C., Biskup, Ewelina, Piza, Petr, Taliadoros, Ioannis, Dey, Nilanjan, Solling, Christoffer, Rasmussen, Bodil Steen, 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, 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, Aidoni, Zoi, Aloizos, Stavros, Tasioudis, Polychronis, Lampiri, Kleri, Zisopoulou, Vasiliki, Ravani, Ifigenia, Pagaki, Eumorfia, Antoniou, Angela, Katsoulas, Theodoros A., Kounougeri, Aikaterini, Marinakis, George, Tsimpoukas, Fotios, Spyropoulou, Anastasia, Zygoulis, Paris, Kyparissi, Aikaterini, Gupta, Manish, Gurjar, Mohan, Maji, Ismail M., Hayes, Ivan, Kelly, Yvelynne, Westbrook, Andrew, Fitzpatrick, Gerry, Maheshwari, Darshana, Motherway, Catherine, Negri, Giovanni, Spadaro, Savino, Nattino, Giuseppe, Pedeferri, Matteo, Boscolo, Annalisa, Rossi, Simona, 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, Adorni, Adele, Bocci, Maria Grazia, Cortegiani, Andrea, Casalicchio, Tiziana, Mellea, Serena, Graziani, Elia, Barattini, Massimo, Brizio, Elisabetta, Rossi, Maurizio, Hahn, Michael, Kemmerer, Nicolai, Strietzel, Hans Frank, Dybwik, Knut, Legernaes, Terje, Klepstad, Pal, Olaussen, Even Braut, Olsen, Knut Inge, Brresen, Ole Marius, Bjorsvik, Geir, Maini, Sameer, Fehrle, Lutz, Czuczwar, Miroslaw, Krawczyk, Pawel, Zietkiewicz, Miroslaw, Nowak, Lukasz R., Kotfis, Katarzyna, Cwyl, Katarzyna, Gajdosz, Ryszard, Biernawska, Jowita, Bohatyrewicz, Romuald, Gawda, Ryszard, Grudzien, Pawel, Nasilowski, Pawel, Popek, Natalia, Cyrankiewicz, Waldemar, Wawrzyniak, Katarzyna, Wnuk, Marek, Maciejewski, Dariusz, Studzinska, Dorota, Zukowski, Maciej, Bernas, Szymon, Piechota, Mariusz, Nowak, Ilona, Fronczek, Jakub, Serwa, Marta, Machala, Waldemar, Stefaniak, Jan, Wujtewicz, Maria, Maciejewski, Pawel, Szymkowiak, Malgorzata, Adamik, Barbara, Catorze, Nuno, Branco, Miguel Castelo, Barros, Ines, 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, Rodriguez, Enver, Rebollo, Sergio, Aguilar, Gerardo, Masdeu, Gaspar, Irazabal Jaimes, Marian, Prado Mira, Angela, Bodi, Maria A., Barea Mendoza, Jesus A., Lopez-Cuenca, Sonia, Homez Guzman, Marcela, Rico-Feijoo, Jesus, Ibarz, Mercedes, Trenado Alvarez, Josep, Kawati, Rafael, Sivik, Joakim, Nauska, Jessica, Smole, Daniel, Parenmark, Fredric, Lyren, Johanna, Rockstroh, Katalin, Ryden, Sara, Spangfors, Martin, Strinnholm, Morten, Walther, Sten, De Geer, Lina, Nordlund, Peter, Palsson, Staffan, Zetterquist, Harald, Nilsson, Annika, Thiringer, Karin, Jungner, Marten, Bark, Bjorn, Nordling, Berit, Skold, Hans, Brorsson, Camilla, Persson, Stefan, Bergstrom, Anna, Berkius, Johan, Holmstrom, Johanna, van Dijk, I, van Lelyveld-Haas, L. E. M., Ramnarain, D., Jansen, Tim, Nooteboom, Fleur, van der Voort, Peter H. J., de Lange, Dylan, Dieperink, Willem, de Waard, Monique C., de Smet, Annemarie G. E., Bormans, Laura, Dormans, Tom, 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, 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, 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, and Nalapko, Yuiry

Abstract

Background: We aimed to evaluate differences in outcome between patients admitted to intensive care unit (ICU) after elective versus acute surgery in a multinational cohort of very old patients (80 years; VIP). Predictors of mortality, with special emphasis on frailty, were assessed. Methods: In total, 5063 VIPs were induded in this analysis, 922 were admitted after elective surgery or intervention, 4141 acutely, with 402 after acute surgery. Differences were calculated using Mann-Whitney-U test and Wilcoxon test. Univariate and multivariable logistic regression were used to assess associations with mortality. Results: Compared patients admitted after acute surgery, patients admitted after elective surgery suffered less often from frailty as defined as CFS (28% vs 46%; p < 0.001), evidenced lower SOFA scores (4 +/- 5 vs 7 +/- 7; p < 0.001). Presence of frailty (CFS >4) was associated with significantly increased mortality both in elective surgery patients (7% vs 12%; p = 0.01), in acute surgery (7% vs 12%; p = 0.02). Conclusions: VIPs admitted to ICU after elective surgery evidenced favorable outcome over patients after acute surgery even after correction for relevant confounders. Frailty might be used to guide clinicians in risk stratification in both patients admitted after elective and acute surgery.

Published
2019
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44. Therapeutic drug monitoring-based dose optimisation of piperacillin/tazobactam to improve outcome in patients with sepsis (TARGET): a prospective, multi-centre, randomised controlled trial

Author

Hagel, Stefan, Fiedler, Sandra, Hohn, Andreas, Brinkmann, Alexander, Frey, Otto R., Hoyer, Heike, Schlattmann, Peter, Kiehntopf, Michael, Roberts, Jason A., Pletz, Mathias W., Bloos, Frank, Angermair, Stefan, Bracht, Hendrik, Barth, Eberhard, Kluge, Stefan, Nierhaus, Axel, Motsch, Johann, Brenner, Thorsten, Annecke, Thorsten, Bach, Friedhelm, Weigand, Markus, Schappacher, Markus, von Ameln-Mayerhofer, Andreas, Michels, Guido, Roehr, Anka, Fuchs, Thomas, Eichner, Sarah, Kong, Christina, Pinder, Nadine, Mueller, Carsten, Petersen, Miriam, Steinbach, Gerald, Jarczak, Dominik, Weisman, Dirk, Kurlbaum, Max, Braune, Anke, Hagel, Stefan, Fiedler, Sandra, Hohn, Andreas, Brinkmann, Alexander, Frey, Otto R., Hoyer, Heike, Schlattmann, Peter, Kiehntopf, Michael, Roberts, Jason A., Pletz, Mathias W., Bloos, Frank, Angermair, Stefan, Bracht, Hendrik, Barth, Eberhard, Kluge, Stefan, Nierhaus, Axel, Motsch, Johann, Brenner, Thorsten, Annecke, Thorsten, Bach, Friedhelm, Weigand, Markus, Schappacher, Markus, von Ameln-Mayerhofer, Andreas, Michels, Guido, Roehr, Anka, Fuchs, Thomas, Eichner, Sarah, Kong, Christina, Pinder, Nadine, Mueller, Carsten, Petersen, Miriam, Steinbach, Gerald, Jarczak, Dominik, Weisman, Dirk, Kurlbaum, Max, and Braune, Anke

Abstract

Background: Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection with a hospital mortality in excess of 40%. Along with insufficient and delayed empirical antimicrobial therapy, inappropriate antimicrobial exposure has been identified to negatively affect patient outcomes. Receipt of prolonged infusion (i.e. extended or continuous infusion) of piperacillin/tazobactam (TZP) improves antimicrobial exposure and is associated with reduced mortality in patients with sepsis. Using therapeutic drug monitoring (TDM) with dosing tailored to the altered pharmacokinetics of the individual patient to avoid under-and overdosing may be a further strategy to improve patient outcomes. This current trial will address the question whether a TDM-guided therapy with TZP administered by continuous infusion will result in a greater resolution of organ dysfunction and hence better clinical outcome compared to continuous infusion of the total daily dose of TZP without TDM. Methods: The study is an investigator-initiated, multi-centre, parallel-group, single-blinded, randomised controlled trial. The trial will be conducted in several centres across Germany. Adult patients (aged >= 18 years) with severe sepsis or septic shock will be eligible for study participation. Participants will be randomly assigned to receive either TZP by continuous infusion guided by daily TDM of piperacillin (experimental group) or by continuous infusion without TDM guidance (total daily dose in normal renal function 13.5 g TZP) (control group). The pharmacokinetic (PK)/ pharmacodynamic (PD) target will be 100% f T->4MIC (percentage of time during a dosing interval that the free [f] drug concentration exceeds 4 times the minimum inhibitory concentration). The primary efficacy endpoint is the change in mean total Sequential Organ Failure Assessment score from day 1 after randomisation until day 10 or discharge from the intensive care unit or death, whichever comes first.

Published
2019

46. Additional file 1: of Clinical Frailty Scale (CFS) reliably stratifies octogenarians in German ICUs: a multicentre prospective cohort study

Author

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

Abstract

Ethics Committees. (DOCX 111 kb)

Published
2018
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47. Clinical Frailty Scale (CFS) reliably stratifies octogenarians in German ICUs : a multicentre prospective cohort study

Author

Müssig, Johanna Maria, 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 Alexander, Meybohm, Patrick, Simon, Philipp, Utzolino, Stefan, Rahmel, Tim, Barth, Eberhard, Schuster, Michael, Kelm, Malte, Jung, Christian, Müssig, Johanna Maria, 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 Alexander, Meybohm, Patrick, Simon, Philipp, Utzolino, Stefan, Rahmel, Tim, Barth, Eberhard, Schuster, Michael, Kelm, Malte, and Jung, Christian

Abstract

Background: In intensive care units (ICU) octogenarians become a routine patients group with aggravated therapeutic and diagnostic decision-making. Due to increased mortality and a reduced quality of life in this high-risk population, medical decision-making a fortiori requires an optimum of risk stratification. Recently, the VIP-1 trial prospectively observed that the clinical frailty scale (CFS) performed well in ICU patients in overall-survival and short-term outcome prediction. However, it is known that healthcare systems differ in the 21 countries contributing to the VIP-1 trial. Hence, our main focus was to investigate whether the CFS is usable for risk stratification in octogenarians admitted to diversified and high tech German ICUs. Methods: This multicentre prospective cohort study analyses very old patients admitted to 20 German ICUs as a sub-analysis of the VIP-1 trial. Three hundred and eight patients of 80 years of age or older admitted consecutively to participating ICUs. CFS, cause of admission, APACHE II, SAPS II and SOFA scores, use of ICU resources and ICU- and 30-day mortality were recorded. Multivariate logistic regression analysis was used to identify factors associated with 30-day mortality. Results: Patients had a median age of 84 [IQR 82–87] years and a mean CFS of 4.75 (± 1.6 standard-deviation) points. More than half of the patients (53.6%) were classified as frail (CFS ≥ 5). ICU-mortality was 17.3% and 30-day mortality was 31.2%. The cause of admission (planned vs. unplanned), (OR 5.74) and the CFS (OR 1.44 per point increase) were independent predictors of 30-day survival. Conclusions: The CFS is an easy determinable valuable tool for prediction of 30-day ICU survival in octogenarians, thus, it may facilitate decision-making for intensive care givers in Germany. Trial registration: The VIP-1 study was retrospectively registered on ClinicalTrials.gov (ID: NCT03134807) on May 1, 2017.

Published
2018

49. Delirium Accompanied by Cholinergic Deficiency and Organ Failure in a 73-Year-Old Critically Ill Patient: Physostigmine as a Therapeutic Option

Author

Zujalovic, Benedikt and Barth, Eberhard

Subjects
Article Subject
Abstract

Delirium is a common problem in ICU patients, resulting in prolonged ICU stay and increased mortality. A cholinergic deficiency in the central nervous system is supposed to be a relevant pathophysiologic process in delirium. Acetylcholine is a major transmitter of the parasympathetic nervous system influencing several organs (e.g., heart and kidneys) and the inflammatory response too. This perception might explain that delirium is not an individual symptom, but rather a part of a symptom complex with various disorders of the whole organism. The cholinergic deficiency could not be quantified up to now. Using the possibility of bedside determination of the acetylcholinesterase activity (AChE activity), we assumed to objectify the cholinergic homeostasis within minutes. As reported here, the postoperative delirium was accompanied by a massive hemodynamic and renal deterioration of unclear genesis. We identified the altered AChE activity as a plausible pathophysiological mechanism. The pharmacological intervention with the indirect parasympathomimetic physostigmine led to a quick and lasting improvement of the patient’s cognitive, hemodynamic, and renal status. In summary, severe delirium is not always an attendant phenomenon of critical illness. It might be causal for multiple organ deterioration if it is based on cholinergic deficiency and has to be treated at his pathophysiological roots whenever possible.

Published
2015
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