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3. Relationship between the Clinical Frailty Scale and short-term mortality in patients ≥ 80 years old acutely admitted to the ICU: a prospective cohort study

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Fronczek, J, Polok, K, de Lange, D, Jung, C, Beil, M, Rhodes, A, Fjolner, J, Gorka, J, Andersen, F, Artigas, A, Cecconi, M, Christensen, S, Joannidis, M, Leaver, S, Marsh, B, Morandi, A, Moreno, R, Oeyen, S, Agvald-Ohman, C, Bollen Pinto, B, Schefold, J, Valentin, A, Walther, S, Watson, X, Zafeiridis, T, Sviri, S, van Heerden, P, Flaatten, H, Guidet, B, Szczeklik, W, Schmutz, R, Wimmer, F, Eller, P, De Buysscher, P, De Neve, N, Swinnen, W, Abraham, P, Hergafi, L, Biskup, E, Piza, P, Taliadoros, I, Dey, N, Solling, C, Rasmussen, B, 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, 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, Aidoni, Z, Aloizos, S, Tasioudis, P, Lampiri, K, Zisopoulou, V, Ravani, I, Pagaki, E, Antoniou, A, Katsoulas, T, Kounougeri, A, Marinakis, G, Tsimpoukas, F, Spyropoulou, A, Zygoulis, P, Kyparissi, A, Gupta, M, Gurjar, M, Maji, I, Hayes, I, Kelly, Y, Westbrook, A, Fitzpatrick, G, Maheshwari, D, Motherway, C, Negri, G, Spadaro, S, Nattino, G, Pedeferri, M, Boscolo, A, Rossi, S, 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, Adorni, A, Bocci, M, Cortegiani, A, Casalicchio, T, Mellea, S, Graziani, E, Barattini, M, Brizio, E, Rossi, M, Hahn, M, Kemmerer, N, Strietzel, H, Dybwik, K, Legernaes, T, Klepstad, P, Olaussen, E, Olsen, K, Brresen, O, Bjorsvik, G, Maini, S, Fehrle, L, Czuczwar, M, Krawczyk, P, Zietkiewicz, M, Nowak, L, Kotfis, K, Cwyl, K, Gajdosz, R, Biernawska, J, Bohatyrewicz, R, Gawda, R, Grudzien, P, Nasilowski, P, Popek, N, Cyrankiewicz, W, Wawrzyniak, K, Wnuk, M, Maciejewski, D, Studzinska, D, Zukowski, M, Bernas, S, Piechota, M, Nowak-Kozka, I, Serwa, M, Machala, W, Stefaniak, J, Wujtewicz, M, Maciejewski, P, Szymkowiak, M, Adamik, B, Catorze, N, Branco, M, Barros, N, Barros, I, 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, Rodriguez, E, Aguilar, G, Masdeu, G, Jaimes, M, Mira, A, Bodi, M, Mendoza, J, Lopez-Cuenca, S, Guzman, M, Rico-Feijoo, J, Ibarz, M, Alvarez, J, Kawati, R, Sivik, J, Nauska, J, Smole, D, Parenmark, F, Lyren, J, Rockstroh, K, Ryden, S, Spangfors, M, Strinnholm, M, 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, van Dijk, I, van Lelyveld-Haas, L, Jansen, T, Nooteboom, F, van der Voort, P, Dieperink, W, de Waard, M, de Smet, A, Bormans, L, Dormans, T, Dempsey, G, Mathew, S, Raj, A, Grecu, I, Cupitt, J, Lawton, T, Clark, R, Popescu, M, Spittle, N, Faulkner, M, Cowton, A, Williams, P, Elloway, E, 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, 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, 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, Nalapko, Y, Helbok, R, Nollet, J, de Neve, N, Mikacic, M, Bastiansen, A, Husted, A, Dahle, B, Cramer, C, Orsnes, D, Thomsen, J, Pedersen, J, Enevoldsen, M, Elkmann, T, Kubisz-Pudelko, A, Collins, A, Hart, C, Randell, G, Filipe, H, Welters, I, Evans, J, Lord, J, Jones, J, Ball, J, North, J, Salaunkey, K, De Gordoa, L, Bell, L, Vizcaychipi, M, Mupudzi, M, Lea-Hagerty, M, Spivey, M, Love, N, White, N, Morgan, P, Wakefield, P, Savine, R, Jacob, R, Innes, R, Rose, S, Mane, T, Ogbeide, V, Baird, Y, Romen, A, Galbois, A, Vinsonneau, C, Thevenin, D, Guerot, E, Savary, G, Chagnon, J, Rigaud, J, Quenot, J, Castaneray, J, Rosman, J, Maizel, J, Tiercelet, K, Hovaere, M, Messika, M, Djibre, M, Rolin, N, Burtin, P, Garcon, P, Nseir, S, Valette, X, Horacek, M, Bruno, R, Allgauer, S, Dubler, S, Schering, S, Koutsikou, A, Vakalos, A, Raitsiou, B, Flioni, E, Neou, E, Papathanakos, G, Koutsodimitropoulos, I, Aikaterini, K, Rovina, N, Kourelea, S, Polychronis, T, Zidianakis, V, Konstantinia, V, Read, C, Martin-Loeches, I, Cracchiolo, A, Morigi, A, Brusa, S, Elhadi, A, Tarek, A, Khaled, A, Ahmed, H, Belkhair, W, Cornet, A, Gommers, D, van Boven, E, Haringman, J, Haas, L, van den Berg, L, Hoiting, O, de Jager, P, Gerritsen, R, Breidablik, A, Slapgard, A, Rime, A, Jannestad, B, Sjoboe, B, Rice, E, Jensen, J, Langorgen, J, Toien, K, Strand, K, Biernacka, A, Kluzik, A, Kudlinski, B, Hymczak, H, Solek-Pastuszka, J, Zorska, J, Krzych, L, Lipinska-Gediga, M, Pietruszko, M, Kozera, N, Sendur, P, Zatorski, P, Galkin, P, Kosciuczuk, U, Gola, W, Pinto, A, Santos, A, Ferreira, I, Blanco, J, Carvalho, J, Maia, J, Candeias, N, Lores, A, Cilloniz, C, Perez-Torres, D, Maseda, E, Prol-Silva, E, Eixarch, G, Goma, G, Velasco, G, Villamayor, M, Fernandez, N, Cubero, P, Tomasa, T, Sjoqvist, A, Schioler, F, Westberg, H, Boroli, F, Eckert, P, Yildiz, I, Yovenko, I, Fronczek J., Polok K., de Lange D. W., Jung C., Beil M., Rhodes A., Fjolner J., Gorka J., Andersen F. H., Artigas A., Cecconi M., Christensen S., Joannidis M., Leaver S., Marsh B., Morandi A., Moreno R., Oeyen S., Agvald-Ohman C., Bollen Pinto B., Schefold J. C., Valentin A., Walther S., Watson X., Zafeiridis T., Sviri S., van Heerden P. V., Flaatten H., Guidet B., Szczeklik W., Schmutz R., Wimmer F., Eller P., De Buysscher P., De Neve N., Swinnen W., Abraham P., Hergafi L., Biskup E., Piza P., Taliadoros I., Dey N., Solling C., Rasmussen B. S., 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., Lauten A., Sacher A. L., Brenner T., Franz M., Bloos F., Ebelt H., Schaller S. J., Fuest K., Rabe C., Dieck T., Steiner S., Graf T., Nia A. M., Janosi R. A., Meybohm P., Simon P., Utzolino S., Rahmel T., Barth E., Schuster M., Aidoni Z., Aloizos S., Tasioudis P., Lampiri K., Zisopoulou V., Ravani I., Pagaki E., Antoniou A., Katsoulas T. A., Kounougeri A., Marinakis G., Tsimpoukas F., Spyropoulou A., Zygoulis P., Kyparissi A., Gupta M., Gurjar M., Maji I. M., Hayes I., Kelly Y., Westbrook A., Fitzpatrick G., Maheshwari D., Motherway C., Negri G., Spadaro S., Nattino G., Pedeferri M., Boscolo A., Rossi S., 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. A., 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., Adorni A., Bocci M. G., Cortegiani A., Casalicchio T., Mellea S., Graziani E., Barattini M., Brizio E., Rossi M., Hahn M., Kemmerer N., Strietzel H. F., Dybwik K., Legernaes T., Klepstad P., Olaussen E. B., Olsen K. I., Brresen O. M., Bjorsvik G., Maini S., Fehrle L., Czuczwar M., Krawczyk P., Zietkiewicz M., Nowak L. R., Kotfis K., Cwyl K., Gajdosz R., Biernawska J., Bohatyrewicz R., Gawda R., Grudzien P., Nasilowski P., Popek N., Cyrankiewicz W., Wawrzyniak K., Wnuk M., Maciejewski D., Studzinska D., Zukowski M., Bernas S., Piechota M., Nowak-Kozka I., Serwa M., Machala W., Stefaniak J., Wujtewicz M., Maciejewski P., Szymkowiak M., Adamik B., Catorze N., Branco M. C., Barros N., Barros I., Krystopchuk A., Honrado T., Sousa C., Munoz F., Rebelo M., Gomes R., Nunes J., Dias C., Fernandes A. M., Petrisor C., Constantin B., Belskiy V., Boskholov B., Rodriguez E., Aguilar G., Masdeu G., Jaimes M. I., Mira A. P., Bodi M. A., Mendoza J. A. B., Lopez-Cuenca S., Guzman M. H., Rico-Feijoo J., Ibarz M., Alvarez J. T., Kawati R., Sivik J., Nauska J., Smole D., Parenmark F., Lyren J., Rockstroh K., Ryden S., Spangfors M., Strinnholm M., 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., van Dijk I., van Lelyveld-Haas L. E. M., Jansen T., Nooteboom F., van der Voort P. H. J., de Lange D., Dieperink W., de Waard M. C., de Smet A. G. E., Bormans L., Dormans T., Dempsey G., Mathew S. J., Raj A. S., Grecu I., Cupitt J., Lawton T., Clark R., Popescu M., Spittle N., Faulkner M., Cowton A., Williams P., Elloway E., 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., 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., 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., Nalapko Y., Helbok R., Nollet J., de Neve N., Mikacic M., Bastiansen A., Husted A., Dahle B. E. S., Cramer C., Orsnes D., Thomsen J. E., Pedersen J. J., Enevoldsen M. H., Elkmann T., Kubisz-Pudelko A., Collins A., Hart C., Randell G., Filipe H., Welters I. D., Evans J., Lord J., Jones J., Ball J., North J., Salaunkey K., De Gordoa L. O. -R., Bell L., Vizcaychipi M., Mupudzi M., Lea-Hagerty M., Spivey M., Love N., White N., Morgan P., Wakefield P., Savine R., Jacob R., Innes R., Rose S., Mane T., Ogbeide V., Baird Y., Romen A., Galbois A., Vinsonneau C., Thevenin D., Guerot E., Savary G., Chagnon J. L., Rigaud J. P., Quenot J. P., Castaneray J., Rosman J., Maizel J., Tiercelet K., Hovaere M. M., Messika M., Djibre M., Rolin N., Burtin P., Garcon P., Nseir S., Valette X., Horacek M., Bruno R. R., Allgauer S., Dubler S., Schering S., Koutsikou A., Vakalos A., Raitsiou B., Flioni E. N., Neou E., Papathanakos G., Koutsodimitropoulos I., Aikaterini K., Rovina N., Kourelea S., Polychronis T., Zidianakis V., Konstantinia V., Read C., Martin-Loeches I., Cracchiolo A. N., Morigi A., Brusa S., Elhadi A., Tarek A., Khaled A., Ahmed H., Belkhair W. A., Cornet A. D., Gommers D., van Boven E., Haringman J., Haas L., van den Berg L., Hoiting O., de Jager P., Gerritsen R. T., Breidablik A., Slapgard A., Rime A. K., Jannestad B., Sjoboe B., Rice E., Jensen J. P., Langorgen J., Toien K., Strand K., Biernacka A., Kluzik A., Kudlinski B., Hymczak H., Solek-Pastuszka J., Zorska J., Krzych L. J., Lipinska-Gediga M., Pietruszko M., Kozera N., Sendur P., Zatorski P., Galkin P., Kosciuczuk U., Gola W., Pinto A. F., Santos A. R., Ferreira I. A., Blanco J. B., Carvalho J. T., Maia J., Candeias N., Lores A., Cilloniz C., Perez-Torres D., Maseda E., Prol-Silva E., Eixarch G., Goma G., Velasco G. N., Villamayor M. I., Fernandez N. L., Cubero P. J., Tomasa T., Sjoqvist A., Schioler F., Westberg H., Thiringer K. K., Boroli F., Eckert P., Yildiz I., Yovenko I., Fronczek, J, Polok, K, de Lange, D, Jung, C, Beil, M, Rhodes, A, Fjolner, J, Gorka, J, Andersen, F, Artigas, A, Cecconi, M, Christensen, S, Joannidis, M, Leaver, S, Marsh, B, Morandi, A, Moreno, R, Oeyen, S, Agvald-Ohman, C, Bollen Pinto, B, Schefold, J, Valentin, A, Walther, S, Watson, X, Zafeiridis, T, Sviri, S, van Heerden, P, Flaatten, H, Guidet, B, Szczeklik, W, Schmutz, R, Wimmer, F, Eller, P, De Buysscher, P, De Neve, N, Swinnen, W, Abraham, P, Hergafi, L, Biskup, E, Piza, P, Taliadoros, I, Dey, N, Solling, C, Rasmussen, B, 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, 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, Aidoni, Z, Aloizos, S, Tasioudis, P, Lampiri, K, Zisopoulou, V, Ravani, I, Pagaki, E, Antoniou, A, Katsoulas, T, Kounougeri, A, Marinakis, G, Tsimpoukas, F, Spyropoulou, A, Zygoulis, P, Kyparissi, A, Gupta, M, Gurjar, M, Maji, I, Hayes, I, Kelly, Y, Westbrook, A, Fitzpatrick, G, Maheshwari, D, Motherway, C, Negri, G, Spadaro, S, Nattino, G, Pedeferri, M, Boscolo, A, Rossi, S, 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, Adorni, A, Bocci, M, Cortegiani, A, Casalicchio, T, Mellea, S, Graziani, E, Barattini, M, Brizio, E, Rossi, M, Hahn, M, Kemmerer, N, Strietzel, H, Dybwik, K, Legernaes, T, Klepstad, P, Olaussen, E, Olsen, K, Brresen, O, Bjorsvik, G, Maini, S, Fehrle, L, Czuczwar, M, Krawczyk, P, Zietkiewicz, M, Nowak, L, Kotfis, K, Cwyl, K, Gajdosz, R, Biernawska, J, Bohatyrewicz, R, Gawda, R, Grudzien, P, Nasilowski, P, Popek, N, Cyrankiewicz, W, Wawrzyniak, K, Wnuk, M, Maciejewski, D, Studzinska, D, Zukowski, M, Bernas, S, Piechota, M, Nowak-Kozka, I, Serwa, M, Machala, W, Stefaniak, J, Wujtewicz, M, Maciejewski, P, Szymkowiak, M, Adamik, B, Catorze, N, Branco, M, Barros, N, Barros, I, 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, Rodriguez, E, Aguilar, G, Masdeu, G, Jaimes, M, Mira, A, Bodi, M, Mendoza, J, Lopez-Cuenca, S, Guzman, M, Rico-Feijoo, J, Ibarz, M, Alvarez, J, Kawati, R, Sivik, J, Nauska, J, Smole, D, Parenmark, F, Lyren, J, Rockstroh, K, Ryden, S, Spangfors, M, Strinnholm, M, 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, van Dijk, I, van Lelyveld-Haas, L, Jansen, T, Nooteboom, F, van der Voort, P, Dieperink, W, de Waard, M, de Smet, A, Bormans, L, Dormans, T, Dempsey, G, Mathew, S, Raj, A, Grecu, I, Cupitt, J, Lawton, T, Clark, R, Popescu, M, Spittle, N, Faulkner, M, Cowton, A, Williams, P, Elloway, E, 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, 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, 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, Nalapko, Y, Helbok, R, Nollet, J, de Neve, N, Mikacic, M, Bastiansen, A, Husted, A, Dahle, B, Cramer, C, Orsnes, D, Thomsen, J, Pedersen, J, Enevoldsen, M, Elkmann, T, Kubisz-Pudelko, A, Collins, A, Hart, C, Randell, G, Filipe, H, Welters, I, Evans, J, Lord, J, Jones, J, Ball, J, North, J, Salaunkey, K, De Gordoa, L, Bell, L, Vizcaychipi, M, Mupudzi, M, Lea-Hagerty, M, Spivey, M, Love, N, White, N, Morgan, P, Wakefield, P, Savine, R, Jacob, R, Innes, R, Rose, S, Mane, T, Ogbeide, V, Baird, Y, Romen, A, Galbois, A, Vinsonneau, C, Thevenin, D, Guerot, E, Savary, G, Chagnon, J, Rigaud, J, Quenot, J, Castaneray, J, Rosman, J, Maizel, J, Tiercelet, K, Hovaere, M, Messika, M, Djibre, M, Rolin, N, Burtin, P, Garcon, P, Nseir, S, Valette, X, Horacek, M, Bruno, R, Allgauer, S, Dubler, S, Schering, S, Koutsikou, A, Vakalos, A, Raitsiou, B, Flioni, E, Neou, E, Papathanakos, G, Koutsodimitropoulos, I, Aikaterini, K, Rovina, N, Kourelea, S, Polychronis, T, Zidianakis, V, Konstantinia, V, Read, C, Martin-Loeches, I, Cracchiolo, A, Morigi, A, Brusa, S, Elhadi, A, Tarek, A, Khaled, A, Ahmed, H, Belkhair, W, Cornet, A, Gommers, D, van Boven, E, Haringman, J, Haas, L, van den Berg, L, Hoiting, O, de Jager, P, Gerritsen, R, Breidablik, A, Slapgard, A, Rime, A, Jannestad, B, Sjoboe, B, Rice, E, Jensen, J, Langorgen, J, Toien, K, Strand, K, Biernacka, A, Kluzik, A, Kudlinski, B, Hymczak, H, Solek-Pastuszka, J, Zorska, J, Krzych, L, Lipinska-Gediga, M, Pietruszko, M, Kozera, N, Sendur, P, Zatorski, P, Galkin, P, Kosciuczuk, U, Gola, W, Pinto, A, Santos, A, Ferreira, I, Blanco, J, Carvalho, J, Maia, J, Candeias, N, Lores, A, Cilloniz, C, Perez-Torres, D, Maseda, E, Prol-Silva, E, Eixarch, G, Goma, G, Velasco, G, Villamayor, M, Fernandez, N, Cubero, P, Tomasa, T, Sjoqvist, A, Schioler, F, Westberg, H, Boroli, F, Eckert, P, Yildiz, I, Yovenko, I, Fronczek J., Polok K., de Lange D. W., Jung C., Beil M., Rhodes A., Fjolner J., Gorka J., Andersen F. H., Artigas A., Cecconi M., Christensen S., Joannidis M., Leaver S., Marsh B., Morandi A., Moreno R., Oeyen S., Agvald-Ohman C., Bollen Pinto B., Schefold J. C., Valentin A., Walther S., Watson X., Zafeiridis T., Sviri S., van Heerden P. V., Flaatten H., Guidet B., Szczeklik W., Schmutz R., Wimmer F., Eller P., De Buysscher P., De Neve N., Swinnen W., Abraham P., Hergafi L., Biskup E., Piza P., Taliadoros I., Dey N., Solling C., Rasmussen B. S., 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., Lauten A., Sacher A. L., Brenner T., Franz M., Bloos F., Ebelt H., Schaller S. J., Fuest K., Rabe C., Dieck T., Steiner S., Graf T., Nia A. M., Janosi R. A., Meybohm P., Simon P., Utzolino S., Rahmel T., Barth E., Schuster M., Aidoni Z., Aloizos S., Tasioudis P., Lampiri K., Zisopoulou V., Ravani I., Pagaki E., Antoniou A., Katsoulas T. A., Kounougeri A., Marinakis G., Tsimpoukas F., Spyropoulou A., Zygoulis P., Kyparissi A., Gupta M., Gurjar M., Maji I. M., Hayes I., Kelly Y., Westbrook A., Fitzpatrick G., Maheshwari D., Motherway C., Negri G., Spadaro S., Nattino G., Pedeferri M., Boscolo A., Rossi S., 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. A., 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., Adorni A., Bocci M. G., Cortegiani A., Casalicchio T., Mellea S., Graziani E., Barattini M., Brizio E., Rossi M., Hahn M., Kemmerer N., Strietzel H. F., Dybwik K., Legernaes T., Klepstad P., Olaussen E. B., Olsen K. I., Brresen O. M., Bjorsvik G., Maini S., Fehrle L., Czuczwar M., Krawczyk P., Zietkiewicz M., Nowak L. R., Kotfis K., Cwyl K., Gajdosz R., Biernawska J., Bohatyrewicz R., Gawda R., Grudzien P., Nasilowski P., Popek N., Cyrankiewicz W., Wawrzyniak K., Wnuk M., Maciejewski D., Studzinska D., Zukowski M., Bernas S., Piechota M., Nowak-Kozka I., Serwa M., Machala W., Stefaniak J., Wujtewicz M., Maciejewski P., Szymkowiak M., Adamik B., Catorze N., Branco M. C., Barros N., Barros I., Krystopchuk A., Honrado T., Sousa C., Munoz F., Rebelo M., Gomes R., Nunes J., Dias C., Fernandes A. M., Petrisor C., Constantin B., Belskiy V., Boskholov B., Rodriguez E., Aguilar G., Masdeu G., Jaimes M. I., Mira A. P., Bodi M. A., Mendoza J. A. B., Lopez-Cuenca S., Guzman M. H., Rico-Feijoo J., Ibarz M., Alvarez J. T., Kawati R., Sivik J., Nauska J., Smole D., Parenmark F., Lyren J., Rockstroh K., Ryden S., Spangfors M., Strinnholm M., 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., van Dijk I., van Lelyveld-Haas L. E. M., Jansen T., Nooteboom F., van der Voort P. H. J., de Lange D., Dieperink W., de Waard M. C., de Smet A. G. E., Bormans L., Dormans T., Dempsey G., Mathew S. J., Raj A. S., Grecu I., Cupitt J., Lawton T., Clark R., Popescu M., Spittle N., Faulkner M., Cowton A., Williams P., Elloway E., 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., 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., 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., Nalapko Y., Helbok R., Nollet J., de Neve N., Mikacic M., Bastiansen A., Husted A., Dahle B. E. S., Cramer C., Orsnes D., Thomsen J. E., Pedersen J. J., Enevoldsen M. H., Elkmann T., Kubisz-Pudelko A., Collins A., Hart C., Randell G., Filipe H., Welters I. D., Evans J., Lord J., Jones J., Ball J., North J., Salaunkey K., De Gordoa L. O. -R., Bell L., Vizcaychipi M., Mupudzi M., Lea-Hagerty M., Spivey M., Love N., White N., Morgan P., Wakefield P., Savine R., Jacob R., Innes R., Rose S., Mane T., Ogbeide V., Baird Y., Romen A., Galbois A., Vinsonneau C., Thevenin D., Guerot E., Savary G., Chagnon J. L., Rigaud J. P., Quenot J. P., Castaneray J., Rosman J., Maizel J., Tiercelet K., Hovaere M. M., Messika M., Djibre M., Rolin N., Burtin P., Garcon P., Nseir S., Valette X., Horacek M., Bruno R. R., Allgauer S., Dubler S., Schering S., Koutsikou A., Vakalos A., Raitsiou B., Flioni E. N., Neou E., Papathanakos G., Koutsodimitropoulos I., Aikaterini K., Rovina N., Kourelea S., Polychronis T., Zidianakis V., Konstantinia V., Read C., Martin-Loeches I., Cracchiolo A. N., Morigi A., Brusa S., Elhadi A., Tarek A., Khaled A., Ahmed H., Belkhair W. A., Cornet A. D., Gommers D., van Boven E., Haringman J., Haas L., van den Berg L., Hoiting O., de Jager P., Gerritsen R. T., Breidablik A., Slapgard A., Rime A. K., Jannestad B., Sjoboe B., Rice E., Jensen J. P., Langorgen J., Toien K., Strand K., Biernacka A., Kluzik A., Kudlinski B., Hymczak H., Solek-Pastuszka J., Zorska J., Krzych L. J., Lipinska-Gediga M., Pietruszko M., Kozera N., Sendur P., Zatorski P., Galkin P., Kosciuczuk U., Gola W., Pinto A. F., Santos A. R., Ferreira I. A., Blanco J. B., Carvalho J. T., Maia J., Candeias N., Lores A., Cilloniz C., Perez-Torres D., Maseda E., Prol-Silva E., Eixarch G., Goma G., Velasco G. N., Villamayor M. I., Fernandez N. L., Cubero P. J., Tomasa T., Sjoqvist A., Schioler F., Westberg H., Thiringer K. K., Boroli F., Eckert P., Yildiz I., and Yovenko I.

Abstract

Background: The Clinical Frailty Scale (CFS) is frequently used to measure frailty in critically ill adults. There is wide variation in the approach to analysing the relationship between the CFS score and mortality after admission to the ICU. This study aimed to evaluate the influence of modelling approach on the association between the CFS score and short-term mortality and quantify the prognostic value of frailty in this context. Methods: We analysed data from two multicentre prospective cohort studies which enrolled intensive care unit patients ≥ 80 years old in 26 countries. The primary outcome was mortality within 30-days from admission to the ICU. Logistic regression models for both ICU and 30-day mortality included the CFS score as either a categorical, continuous or dichotomous variable and were adjusted for patient’s age, sex, reason for admission to the ICU, and admission Sequential Organ Failure Assessment score. Results: The median age in the sample of 7487 consecutive patients was 84 years (IQR 81–87). The highest fraction of new prognostic information from frailty in the context of 30-day mortality was observed when the CFS score was treated as either a categorical variable using all original levels of frailty or a nonlinear continuous variable and was equal to 9% using these modelling approaches (p < 0.001). The relationship between the CFS score and mortality was nonlinear (p < 0.01). Conclusion: Knowledge about a patient’s frailty status adds a substantial amount of new prognostic information at the moment of admission to the ICU. Arbitrary simplification of the CFS score into fewer groups than originally intended leads to a loss of information and should be avoided. Trial registration NCT03134807 (VIP1), NCT03370692 (VIP2)

Published
2021

4. Sepsis at ICU admission does not decrease 30-day survival in very old patients: a post-hoc analysis of the VIP1 multinational cohort study

Author

Ibarz, M, Boumendil, A, Haas, L, Irazabal, M, Flaatten, H, de Lange, D, Morandi, A, Andersen, F, Bertolini, G, Cecconi, M, Christensen, S, Faraldi, L, Fjolner, J, Jung, C, Marsh, B, Moreno, R, Oeyen, S, Ohman, C, Bollen Pinto, B, Soliman, I, Szczeklik, W, Valentin, A, Watson, X, Zaferidis, T, Guidet, B, Artigas, A, Schmutz, R, Wimmer, F, Eller, P, Joannidis, M, De Buysscher, P, De Neve, N, Swinnen, W, Abraham, P, Hergafi, L, Schefold, J, Biskup, E, Piza, P, Taliadoros, I, Dey, N, Solling, C, Rasmussen, B, 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, 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, Aidoni, Z, Aloizos, S, Tasioudis, P, Lampiri, K, Zisopoulou, V, Ravani, I, Pagaki, E, Antoniou, A, Katsoulas, T, Kounougeri, A, Marinakis, G, Tsimpoukas, F, Spyropoulou, A, Zygoulis, P, Kyparissi, A, Gupta, M, Gurjar, M, Maji, I, Hayes, I, Kelly, Y, Westbrook, A, Fitzpatrick, G, Maheshwari, D, Motherway, C, Negri, G, Spadaro, S, Nattino, G, Pedeferri, M, Boscolo, A, Rossi, S, 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, Adorni, A, Bocci, M, Cortegiani, A, Casalicchio, T, Melia, S, Graziani, E, Barattini, M, Brizio, E, Rossi, M, Hahn, M, Flattens, H, Kemmerer, N, Streiter, H, Dybwik, K, Legernaes, T, Klepstad, P, Olaussen, E, Olsen, K, Brresen, O, Bjorsvik, G, Maini, S, Fehrle, L, Krawczyk, P, Zietkiewicz, M, Nowak, L, Kotfis, K, Cwyl, K, Gajdosz, R, Biernawska, J, Bohatyrewicz, R, Gawda, R, Grudzien, P, Nasilowski, P, Popek, N, Cyrankiewicz, W, Wawrzyniak, K, Wnuk, M, Maciejewski, D, Studzinska, D, Zukowski, M, Bernas, S, Piechota, M, Nowak-Kozka, I, Fronczek, J, Serwa, M, Stefaniak, J, Wujtewicz, M, Szymkowiak, M, Adamik, B, Polok, K, Wludarczyk, A, Gorka, J, Kozera, N, Gozdzik, W, Catorze, N, 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, Rodriguez, E, Rebollo, S, Aguilar, G, Masdeu, G, Jaimes, M, Mira, A, Bodi, M, Barea Mendoza, J, Lopez-Cuenca, S, Guzman, M, Rico-Feijoo, J, Alvarez, J, Kawati, R, Sivik, J, Nauska, J, Parenmark, F, Lyren, J, Rockstrohm, 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, van Dijk, I, Ramnarain, D, Jansen, T, Nooteboom, F, van der Voort, P, Dieperink, W, de Waard, M, de Smet, A, Bormans, L, Dormans, T, 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, 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, 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, Nalapko, Y, Ibarz M., Boumendil A., Haas L. E. M., Irazabal M., Flaatten H., de Lange D. W., Morandi A., Andersen F. H., Bertolini G., Cecconi M., Christensen S., Faraldi L., Fjolner J., Jung C., Marsh B., Moreno R., Oeyen S., Ohman C. A., Bollen Pinto B., Soliman I. W., Szczeklik W., Valentin A., Watson X., Zaferidis T., Guidet B., Artigas A., Schmutz R., Wimmer F., Eller P., Joannidis M., De Buysscher P., De Neve N., Swinnen W., Abraham P., Hergafi L., Schefold J. C., Biskup E., Piza P., Taliadoros I., Dey N., Solling C., Rasmussen B. S., 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., Lauten A., Sacher A. L., Brenner T., Franz M., Bloos F., Ebelt H., Schaller S. J., Fuest K., Rabe C., Dieck T., Steiner S., Graf T., Nia A. M., Janosi R. A., Meybohm P., Simon P., Utzolino S., Rahmel T., Barth E., Schuster M., Aidoni Z., Aloizos S., Tasioudis P., Lampiri K., Zisopoulou V., Ravani I., Pagaki E., Antoniou A., Katsoulas T. A., Kounougeri A., Marinakis G., Tsimpoukas F., Spyropoulou A., Zygoulis P., Kyparissi A., Gupta M., Gurjar M., Maji I. M., Hayes I., Kelly Y., Westbrook A., Fitzpatrick G., Maheshwari D., Motherway C., Negri G., Spadaro S., Nattino G., Pedeferri M., Boscolo A., Rossi S., 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. A., 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., Adorni A., Bocci M. G., Cortegiani A., Casalicchio T., Melia S., Graziani E., Barattini M., Brizio E., Rossi M., Hahn M., Flattens H., Kemmerer N., Streiter H. F., Dybwik K., Legernaes T., Klepstad P., Olaussen E. B., Olsen K. I., Brresen O. M., Bjorsvik G., Maini S., Fehrle L., Krawczyk P., Zietkiewicz M., Nowak L. R., Kotfis K., Cwyl K., Gajdosz R., Biernawska J., Bohatyrewicz R., Gawda R., Grudzien P., Nasilowski P., Popek N., Cyrankiewicz W., Wawrzyniak K., Wnuk M., Maciejewski D., Studzinska D., Zukowski M., Bernas S., Piechota M., Nowak-Kozka I., Fronczek J., Serwa M., Stefaniak J., Wujtewicz M., Szymkowiak M., Adamik B., Polok K., Wludarczyk A., Gorka J., Kozera N., Gozdzik W., Catorze N., Branco M. C., Barros I., Barros N., Krystopchuk A., Honrado T., Sousa C., Munoz F., Rebelo M., Gomes R., Nunes J., Dias C., Fernandes A. M., Petrisor C., Constantin B., Belskiy V., Boskholov B., Rodriguez E., Rebollo S., Aguilar G., Masdeu G., Jaimes M. I., Mira A. P., Bodi M. A., Barea Mendoza J. A., Lopez-Cuenca S., Guzman M. H., Rico-Feijoo J., Alvarez J. T., Kawati R., Sivik J., Nauska J., Parenmark F., Lyren J., Rockstrohm 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., van Dijk I., Ramnarain D., Jansen T., Nooteboom F., van der Voort P. H. J., Dieperink W., de Waard M. C., de Smet A. G. E., Bormans L., Dormans T., Dempsey G., Mathew S. J., Raj A. S., 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., 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., 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., Nalapko Y., Ibarz, M, Boumendil, A, Haas, L, Irazabal, M, Flaatten, H, de Lange, D, Morandi, A, Andersen, F, Bertolini, G, Cecconi, M, Christensen, S, Faraldi, L, Fjolner, J, Jung, C, Marsh, B, Moreno, R, Oeyen, S, Ohman, C, Bollen Pinto, B, Soliman, I, Szczeklik, W, Valentin, A, Watson, X, Zaferidis, T, Guidet, B, Artigas, A, Schmutz, R, Wimmer, F, Eller, P, Joannidis, M, De Buysscher, P, De Neve, N, Swinnen, W, Abraham, P, Hergafi, L, Schefold, J, Biskup, E, Piza, P, Taliadoros, I, Dey, N, Solling, C, Rasmussen, B, 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, 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, Aidoni, Z, Aloizos, S, Tasioudis, P, Lampiri, K, Zisopoulou, V, Ravani, I, Pagaki, E, Antoniou, A, Katsoulas, T, Kounougeri, A, Marinakis, G, Tsimpoukas, F, Spyropoulou, A, Zygoulis, P, Kyparissi, A, Gupta, M, Gurjar, M, Maji, I, Hayes, I, Kelly, Y, Westbrook, A, Fitzpatrick, G, Maheshwari, D, Motherway, C, Negri, G, Spadaro, S, Nattino, G, Pedeferri, M, Boscolo, A, Rossi, S, 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, Adorni, A, Bocci, M, Cortegiani, A, Casalicchio, T, Melia, S, Graziani, E, Barattini, M, Brizio, E, Rossi, M, Hahn, M, Flattens, H, Kemmerer, N, Streiter, H, Dybwik, K, Legernaes, T, Klepstad, P, Olaussen, E, Olsen, K, Brresen, O, Bjorsvik, G, Maini, S, Fehrle, L, Krawczyk, P, Zietkiewicz, M, Nowak, L, Kotfis, K, Cwyl, K, Gajdosz, R, Biernawska, J, Bohatyrewicz, R, Gawda, R, Grudzien, P, Nasilowski, P, Popek, N, Cyrankiewicz, W, Wawrzyniak, K, Wnuk, M, Maciejewski, D, Studzinska, D, Zukowski, M, Bernas, S, Piechota, M, Nowak-Kozka, I, Fronczek, J, Serwa, M, Stefaniak, J, Wujtewicz, M, Szymkowiak, M, Adamik, B, Polok, K, Wludarczyk, A, Gorka, J, Kozera, N, Gozdzik, W, Catorze, N, 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, Rodriguez, E, Rebollo, S, Aguilar, G, Masdeu, G, Jaimes, M, Mira, A, Bodi, M, Barea Mendoza, J, Lopez-Cuenca, S, Guzman, M, Rico-Feijoo, J, Alvarez, J, Kawati, R, Sivik, J, Nauska, J, Parenmark, F, Lyren, J, Rockstrohm, 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, van Dijk, I, Ramnarain, D, Jansen, T, Nooteboom, F, van der Voort, P, Dieperink, W, de Waard, M, de Smet, A, Bormans, L, Dormans, T, 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, 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, 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, Nalapko, Y, Ibarz M., Boumendil A., Haas L. E. M., Irazabal M., Flaatten H., de Lange D. W., Morandi A., Andersen F. H., Bertolini G., Cecconi M., Christensen S., Faraldi L., Fjolner J., Jung C., Marsh B., Moreno R., Oeyen S., Ohman C. A., Bollen Pinto B., Soliman I. W., Szczeklik W., Valentin A., Watson X., Zaferidis T., Guidet B., Artigas A., Schmutz R., Wimmer F., Eller P., Joannidis M., De Buysscher P., De Neve N., Swinnen W., Abraham P., Hergafi L., Schefold J. C., Biskup E., Piza P., Taliadoros I., Dey N., Solling C., Rasmussen B. S., 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., Lauten A., Sacher A. L., Brenner T., Franz M., Bloos F., Ebelt H., Schaller S. J., Fuest K., Rabe C., Dieck T., Steiner S., Graf T., Nia A. M., Janosi R. A., Meybohm P., Simon P., Utzolino S., Rahmel T., Barth E., Schuster M., Aidoni Z., Aloizos S., Tasioudis P., Lampiri K., Zisopoulou V., Ravani I., Pagaki E., Antoniou A., Katsoulas T. A., Kounougeri A., Marinakis G., Tsimpoukas F., Spyropoulou A., Zygoulis P., Kyparissi A., Gupta M., Gurjar M., Maji I. M., Hayes I., Kelly Y., Westbrook A., Fitzpatrick G., Maheshwari D., Motherway C., Negri G., Spadaro S., Nattino G., Pedeferri M., Boscolo A., Rossi S., 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. A., 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., Adorni A., Bocci M. G., Cortegiani A., Casalicchio T., Melia S., Graziani E., Barattini M., Brizio E., Rossi M., Hahn M., Flattens H., Kemmerer N., Streiter H. F., Dybwik K., Legernaes T., Klepstad P., Olaussen E. B., Olsen K. I., Brresen O. M., Bjorsvik G., Maini S., Fehrle L., Krawczyk P., Zietkiewicz M., Nowak L. R., Kotfis K., Cwyl K., Gajdosz R., Biernawska J., Bohatyrewicz R., Gawda R., Grudzien P., Nasilowski P., Popek N., Cyrankiewicz W., Wawrzyniak K., Wnuk M., Maciejewski D., Studzinska D., Zukowski M., Bernas S., Piechota M., Nowak-Kozka I., Fronczek J., Serwa M., Stefaniak J., Wujtewicz M., Szymkowiak M., Adamik B., Polok K., Wludarczyk A., Gorka J., Kozera N., Gozdzik W., Catorze N., Branco M. C., Barros I., Barros N., Krystopchuk A., Honrado T., Sousa C., Munoz F., Rebelo M., Gomes R., Nunes J., Dias C., Fernandes A. M., Petrisor C., Constantin B., Belskiy V., Boskholov B., Rodriguez E., Rebollo S., Aguilar G., Masdeu G., Jaimes M. I., Mira A. P., Bodi M. A., Barea Mendoza J. A., Lopez-Cuenca S., Guzman M. H., Rico-Feijoo J., Alvarez J. T., Kawati R., Sivik J., Nauska J., Parenmark F., Lyren J., Rockstrohm 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., van Dijk I., Ramnarain D., Jansen T., Nooteboom F., van der Voort P. H. J., Dieperink W., de Waard M. C., de Smet A. G. E., Bormans L., Dormans T., Dempsey G., Mathew S. J., Raj A. S., 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., 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., 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., and Nalapko Y.

Abstract

Background: The number of intensive care patients aged ≥ 80 years (Very old Intensive Care Patients; VIPs) is growing. VIPs have high mortality and morbidity and the benefits of ICU admission are frequently questioned. Sepsis incidence has risen in recent years and identification of outcomes is of considerable public importance. We aimed to determine whether VIPs admitted for sepsis had different outcomes than those admitted for other acute reasons and identify potential prognostic factors for 30-day survival. Results: This prospective study included VIPs with Sequential Organ Failure Assessment (SOFA) scores ≥ 2 acutely admitted to 307 ICUs in 21 European countries. Of 3869 acutely admitted VIPs, 493 (12.7%) [53.8% male, median age 83 (81–86) years] were admitted for sepsis. Sepsis was defined according to clinical criteria; suspected or demonstrated focus of infection and SOFA score ≥ 2 points. Compared to VIPs admitted for other acute reasons, VIPs admitted for sepsis were younger, had a higher SOFA score (9 vs. 7, p < 0.0001), required more vasoactive drugs [82.2% vs. 55.1%, p < 0.0001] and renal replacement therapies [17.4% vs. 9.9%; p < 0.0001], and had more life-sustaining treatment limitations [37.3% vs. 32.1%; p = 0.02]. Frailty was similar in both groups. Unadjusted 30-day survival was not significantly different between the two groups. After adjustment for age, gender, frailty, and SOFA score, sepsis had no impact on 30-day survival [HR 0.99 (95% CI 0.86–1.15), p = 0.917]. Inverse-probability weight (IPW)-adjusted survival curves for the first 30 days after ICU admission were similar for acute septic and non-septic patients [HR: 1.00 (95% CI 0.87–1.17), p = 0.95]. A matched-pair analysis in which patients with sepsis were matched with two control patients of the same gender with the same age, SOFA score, and level of frailty was also performed. A Cox proportional hazard regression model stratified on the matched pairs showed that 30-day

Published
2020

5. Sepsis at ICU admission does not decrease 30-day survival in very old patients : a post-hoc analysis of the VIP1 multinational cohort study

Author

Ibarz, Mercedes, Boumendil, Ariane, Haas, Lenneke E M, Irazabal, Marian, Flaatten, Hans, de Lange, Dylan W, Morandi, Alessandro, Andersen, Finn H, Bertolini, Guido, Cecconi, Maurizio, Christensen, Steffen, Faraldi, Loredana, Fjølner, Jesper, Jung, Christian, Marsh, Brian, Moreno, Rui, Oeyen, Sandra, Öhman, Christina Agwald, Bollen Pinto, Bernardo, Soliman, Ivo W, Szczeklik, Wojciech, Valentin, Andreas, Watson, Ximena, Zaferidis, Tilemachos, Guidet, Bertrand, Artigas, Antonio, Schmutz R, Wimmer F, Eller P, Joannidis M, De Buysscher P, De Neve N, Oeyen S, Swinnen W, Bollen Pinto B, Abraham P, Hergafi L, Schefold JC, Biskup E, Piza P, Taliadoros I, Fjølner J, Dey N, Sølling C, Rasmussen BS, Christensen S, 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, Guidet B, Charron C, Lauten A, Sacher AL, Brenner T, Franz M, Bloos F, Ebelt H, Schaller SJ, Fuest K, Rabe C, Dieck T, Steiner S, Graf T, Nia AM, Jung C, Janosi RA, Meybohm P, Simon P, Utzolino S, Rahmel T, Barth E, Schuster M, Aidoni Z, Aloizos S, Tasioudis P, Lampiri K, Zisopoulou V, Ravani I, Pagaki E, Antoniou A, Katsoulas TA, Kounougeri A, Marinakis G, Tsimpoukas F, Spyropoulou A, Zygoulis P, Kyparissi A, Gupta M, Gurjar M, Maji IM, Hayes I, Marsh B, Kelly Y, Westbrook A, Fitzpatrick G, Maheshwari D, Motherway C, Negri G, Spadaro S, Nattino G, Pedeferri M, Boscolo A, Rossi S, Calicchio G, Cubattoli L, Di Lascio G, Barbagallo M, Berruto F, Codazzi D, Bottazzi A, Fumagalli P, Negro G, Lupi G, Savelli F, Vulcano GA, 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, Adorni A, Bocci MG, Cortegiani A, Casalicchio T, Melia S, Graziani E, Barattini M, Brizio E, Rossi M, Hahn M, Flattens H, Kemmerer N, Streiter HF, Dybwik K, Legernaes T, Klepstad P, Olaussen EB, Olsen KI, Brresen OM, Bjorsvik G, Andersen FH, Maini S, Fehrle L, Czuczwar M, Krawczyk P, Ziętkiewicz M, Nowak ŁR, Kotfis K, Cwyl K, Gajdosz R, Biernawska J, Bohatyrewicz R, Gawda R, Grudzień P, Nasiłowski P, Popek N, Cyrankiewicz W, Wawrzyniak K, Wnuk M, Maciejewski D, Studzińska D, Żukowski M, Bernas S, Piechota M, Szczeklik W, Nowak-Kózka I, Fronczek J, Serwa M, Machała W, Stefaniak J, Wujtewicz M, Szymkowiak M, Adamik B, Polok K, Włudarczyk A, Górka J, Kozera N, Goździk W, Catorze N, Branco MC, Barros I, Barros N, Krystopchuk A, Honrado T, Sousa C, Munoz F, Rebelo M, Gomes R, Nunes J, Dias C, Fernandes AM, Petrisor C, Constantin B, Belskiy V, Boskholov B, Rodriguez E, Rebollo S, Aguilar G, Masdeu G, Jaimes MI, Mira ÁP, Bodi MA, Barea Mendoza JA, López-Cuenca S, Guzman MH, Rico-Feijoo J, Ibarz M, Alvarez JT, Kawati R, Sivik J, Nauska J, Smole D, Parenmark F, Lyrén J, Rockstrohm K, Rydén S, Spångfors M, Strinnholm M, Walther S, De Geer L, Nordlund P, Pålsson S, Zetterquist H, Nilsson A, Thiringer K, Jungner M, Bark B, Nordling B, Sköld H, Brorsson C, Persson S, Bergström A, Berkius J, Holmström J, van Dijk I, Haas LEM, Ramnarain D, Jansen T, Nooteboom F, van der Voort PHJ, de Lange D, Dieperink W, de Waard MC, de Smet AGE, Bormans L, Dormans T, Dempsey G, Mathew SJ, Raj AS, 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, 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, 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, Nalapko Y., Ibarz, M, Boumendil, A, Haas, L, Irazabal, M, Flaatten, H, de Lange, D, Morandi, A, Andersen, F, Bertolini, G, Cecconi, M, Christensen, S, Faraldi, L, Fjolner, J, Jung, C, Marsh, B, Moreno, R, Oeyen, S, Ohman, C, Bollen Pinto, B, Soliman, I, Szczeklik, W, Valentin, A, Watson, X, Zaferidis, T, Guidet, B, Artigas, A, Schmutz, R, Wimmer, F, Eller, P, Joannidis, M, De Buysscher, P, De Neve, N, Swinnen, W, Abraham, P, Hergafi, L, Schefold, J, Biskup, E, Piza, P, Taliadoros, I, Dey, N, Solling, C, Rasmussen, B, 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, 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, Aidoni, Z, Aloizos, S, Tasioudis, P, Lampiri, K, Zisopoulou, V, Ravani, I, Pagaki, E, Antoniou, A, Katsoulas, T, Kounougeri, A, Marinakis, G, Tsimpoukas, F, Spyropoulou, A, Zygoulis, P, Kyparissi, A, Gupta, M, Gurjar, M, Maji, I, Hayes, I, Kelly, Y, Westbrook, A, Fitzpatrick, G, Maheshwari, D, Motherway, C, Negri, G, Spadaro, S, Nattino, G, Pedeferri, M, Boscolo, A, Rossi, S, 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, Adorni, A, Bocci, M, Cortegiani, A, Casalicchio, T, Melia, S, Graziani, E, Barattini, M, Brizio, E, Rossi, M, Hahn, M, Flattens, H, Kemmerer, N, Streiter, H, Dybwik, K, Legernaes, T, Klepstad, P, Olaussen, E, Olsen, K, Brresen, O, Bjorsvik, G, Maini, S, Fehrle, L, Krawczyk, P, Zietkiewicz, M, Nowak, L, Kotfis, K, Cwyl, K, Gajdosz, R, Biernawska, J, Bohatyrewicz, R, Gawda, R, Grudzien, P, Nasilowski, P, Popek, N, Cyrankiewicz, W, Wawrzyniak, K, Wnuk, M, Maciejewski, D, Studzinska, D, Zukowski, M, Bernas, S, Piechota, M, Nowak-Kozka, I, Fronczek, J, Serwa, M, Stefaniak, J, Wujtewicz, M, Szymkowiak, M, Adamik, B, Polok, K, Wludarczyk, A, Gorka, J, Kozera, N, Gozdzik, W, Catorze, N, 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, Rodriguez, E, Rebollo, S, Aguilar, G, Masdeu, G, Jaimes, M, Mira, A, Bodi, M, Barea Mendoza, J, Lopez-Cuenca, S, Guzman, M, Rico-Feijoo, J, Alvarez, J, Kawati, R, Sivik, J, Nauska, J, Parenmark, F, Lyren, J, Rockstrohm, 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, van Dijk, I, Ramnarain, D, Jansen, T, Nooteboom, F, van der Voort, P, Dieperink, W, de Waard, M, de Smet, A, Bormans, L, Dormans, T, 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, 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, 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, Nalapko, Y, Ibarz, Mercede, Boumendil, Ariane, Haas, Lenneke E M, Irazabal, Marian, Flaatten, Han, de Lange, Dylan W, Morandi, Alessandro, Andersen, Finn H, Bertolini, Guido, Cecconi, Maurizio, Christensen, Steffen, Faraldi, Loredana, Fjølner, Jesper, Jung, Christian, Marsh, Brian, Moreno, Rui, Oeyen, Sandra, Öhman, Christina Agwald, Bollen Pinto, Bernardo, Soliman, Ivo W, Szczeklik, Wojciech, Valentin, Andrea, Watson, Ximena, Zaferidis, Tilemacho, Guidet, Bertrand, Artigas, Antonio, Schmutz R, Wimmer F, Eller P, Joannidis M, De Buysscher P, De Neve N, Oeyen S, Swinnen W, Bollen Pinto B, Abraham P, Hergafi L, Schefold JC, Biskup E, Piza P, Taliadoros I, Fjølner J, Dey N, Sølling C, Rasmussen BS, Christensen S, Forceville X, Besch G, Mentec H, Michel P, Mateu P, Michel P, Vettoretti L, Bourenne J, Marin N, Guillot M, Aissaoui N, Goulenok C, Thieulot-Rolin N, Messika J, Lamhaut L, Guidet B, Charron C, Lauten A, Sacher AL, Brenner T, Franz M, Bloos F, Ebelt H, Schaller SJ, Fuest K, Rabe C, Dieck T, Steiner S, Graf T, Nia AM, Jung C, Janosi RA, Meybohm P, Simon P, Utzolino S, Rahmel T, Barth E, Jung C, Schuster M, Aidoni Z, Aloizos S, Tasioudis P, Lampiri K, Zisopoulou V, Ravani I, Pagaki E, Antoniou A, Katsoulas TA, Kounougeri A, Marinakis G, Tsimpoukas F, Spyropoulou A, Zygoulis P, Kyparissi A, Gupta M, Gurjar M, Maji IM, Hayes I, Marsh B, Kelly Y, Westbrook A, Fitzpatrick G, Maheshwari D, Motherway C, Negri G, Spadaro S, Nattino G, Pedeferri M, Boscolo A, Rossi S, Calicchio G, Cubattoli L, Di Lascio G, Barbagallo M, Berruto F, Codazzi D, Bottazzi A, Fumagalli P, Negro G, Lupi G, Savelli F, Vulcano GA, 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, Adorni A, Bocci MG, Cortegiani A, Casalicchio T, Melia S, Graziani E, Barattini M, Brizio E, Rossi M, Hahn M, Flattens H, Kemmerer N, Streiter HF, Dybwik K, Legernaes T, Klepstad P, Olaussen EB, Olsen KI, Brresen OM, Bjorsvik G, Andersen FH, Maini S, Fehrle L, Czuczwar M, Krawczyk P, Ziętkiewicz M, Nowak ŁR, Kotfis K, Cwyl K, Gajdosz R, Biernawska J, Bohatyrewicz R, Gawda R, Grudzień P, Nasiłowski P, Popek N, Cyrankiewicz W, Wawrzyniak K, Wnuk M, Maciejewski D, Studzińska D, Żukowski M, Bernas S, Piechota M, Szczeklik W, Nowak-Kózka I, Fronczek J, Serwa M, Machała W, Stefaniak J, Wujtewicz M, Szymkowiak M, Adamik B, Polok K, Włudarczyk A, Górka J, Kozera N, Goździk W, Catorze N, Branco MC, Barros I, Barros N, Krystopchuk A, Honrado T, Sousa C, Munoz F, Rebelo M, Gomes R, Nunes J, Dias C, Fernandes AM, Petrisor C, Constantin B, Belskiy V, Boskholov B, Rodriguez E, Rebollo S, Aguilar G, Masdeu G, Jaimes MI, Mira ÁP, Bodi MA, Barea Mendoza JA, López-Cuenca S, Guzman MH, Rico-Feijoo J, Ibarz M, Alvarez JT, Kawati R, Sivik J, Nauska J, Smole D, Parenmark F, Lyrén J, Rockstrohm K, Rydén S, Spångfors M, Strinnholm M, Walther S, De Geer L, Nordlund P, Pålsson S, Zetterquist H, Nilsson A, Thiringer K, Jungner M, Bark B, Nordling B, Sköld H, Brorsson C, Persson S, Bergström A, Berkius J, Holmström J, van Dijk I, Haas LEM, Ramnarain D, Jansen T, Nooteboom F, van der Voort PHJ, de Lange D, Dieperink W, de Waard MC, de Smet AGE, Bormans L, Dormans T, Dempsey G, Mathew SJ, Raj AS, 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, 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, Grecu I, Craig J, Prowle J, Doyle N, Shelton J, Scott C, Donnison P, Shelton S, Frey C, Ryan C, Spray D, Ryan C, Barnes V, Barnes K, Ridgway S, Saha R, Kent L, Clark T, Wood J, Bolger C, Bassford C, Cowton A, Lewandowski J, Zhao X, Humphreys S, Dowling S, Richardson N, Burtenshaw A, Stevenson C, Wilcock D, Nalapko Y., Critical Care, and Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE)

Subjects
INTENSIVE-CARE-UNIT, Survival, HSJ UCI, Critical Care and Intensive Care Medicine, survival analysis, law.invention, sepsis, Severity of illne, 0302 clinical medicine, LONG-TERM OUTCOMES, overlevingsanalyse, law, Medicine and Health Sciences, EPIDEMIOLOGY, Intensive care, Mortality, Outcome, Sepsis, Severity of illness, Very old, 030212 general & internal medicine, Prospective cohort study, ELDERLY-PATIENTS, ddc:617, PATIENTS AGED 80, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Very Old, Intensive care unit, SOFA score, medicine.symptom, CRITICALLY-ILL PATIENTS, WITHDRAWAL, hormones, hormone substitutes, and hormone antagonists, medicine.medical_specialty, Sepsi, elderly patients, NO, 03 medical and health sciences, sterfte, Internal medicine, medicine, FRAILTY, business.industry, Septic shock, Research, SEPTIC SHOCK, Organ dysfunction, Intensive Care, 030208 emergency & critical care medicine, lcsh:RC86-88.9, oudere patiënten, medicine.disease, business
Abstract

BackgroundThe number of intensive care patients aged ≥ 80 years (Very old Intensive Care Patients; VIPs) is growing. VIPs have high mortality and morbidity and the benefits of ICU admission are frequently questioned. Sepsis incidence has risen in recent years and identification of outcomes is of considerable public importance. We aimed to determine whether VIPs admitted for sepsis had different outcomes than those admitted for other acute reasons and identify potential prognostic factors for 30-day survival.ResultsThis prospective study included VIPs with Sequential Organ Failure Assessment (SOFA) scores ≥ 2 acutely admitted to 307 ICUs in 21 European countries. Of 3869 acutely admitted VIPs, 493 (12.7%) [53.8% male, median age 83 (81–86) years] were admitted for sepsis. Sepsis was defined according to clinical criteria; suspected or demonstrated focus of infection and SOFA score ≥ 2 points. Compared to VIPs admitted for other acute reasons, VIPs admitted for sepsis were younger, had a higher SOFA score (9 vs. 7,p p p p = 0.02]. Frailty was similar in both groups. Unadjusted 30-day survival was not significantly different between the two groups. After adjustment for age, gender, frailty, and SOFA score, sepsis had no impact on 30-day survival [HR 0.99 (95% CI 0.86–1.15),p = 0.917]. Inverse-probability weight (IPW)-adjusted survival curves for the first 30 days after ICU admission were similar for acute septic and non-septic patients [HR: 1.00 (95% CI 0.87–1.17),p = 0.95]. A matched-pair analysis in which patients with sepsis were matched with two control patients of the same gender with the same age, SOFA score, and level of frailty was also performed. A Cox proportional hazard regression model stratified on the matched pairs showed that 30-day survival was similar in both groups [57.2% (95% CI 52.7–60.7) vs. 57.1% (95% CI 53.7–60.1),p = 0.85].ConclusionsAfter adjusting for organ dysfunction, sepsis at admission was not independently associated with decreased 30-day survival in this multinational study of 3869 VIPs. Age, frailty, and SOFA score were independently associated with survival.

Published
2020

6. Cumulative Prognostic Score Predicting Mortality in Patients Older Than 80 Years Admitted to the ICU

Author

de Lange, D, Brinkman, S, Flaatten, H, Boumendil, A, Morandi, A, Andersen, F, Artigas, A, Bertolini, G, Cecconi, M, Christensen, S, Faraldi, L, Fjolner, J, Jung, C, Marsh, B, Favarato, M, Oeyen, S, Ohman, C, Bollen Pinto, B, de Smet, A, Soliman, I, Szczeklik, W, Valentin, A, Watson, X, Zafeiridis, T, Guidet, B, Schmutz, R, Wimmer, F, Eller, P, Joannidis, M, De Buysscher, P, De Neve, N, Swinnen, W, Abraham, P, Hergafi, L, Schefold, J, Biskup, E, Piza, P, Taliadoros, I, Dey, N, Solling, C, Rasmussen, B, 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, 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, Aidoni, Z, Aloizos, S, Tasioudis, P, Lampiri, K, Zisopoulou, V, Ravani, I, Pagaki, E, Antoniou, A, Katsoulas, T, Kounougeri, A, Marinakis, G, Tsimpoukas, F, Spyropoulou, A, Zygoulis, P, Kyparissi, A, Gupta, M, Gurjar, M, Maji, I, Hayes, I, Kelly, Y, Westbrook, A, Fitzpatrick, G, Maheshwari, D, Motherway, C, Negri, G, Spadaro, S, Nattino, G, Pedeferri, M, Boscolo, A, Rossi, S, 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, Adorni, A, Bocci, M, Cortegiani, A, Casalicchio, T, Mellea, S, Graziani, E, Barattini, M, Brizio, E, Rossi, M, Hahn, M, Kemmerer, N, Strietzel, H, Dybwik, K, Legernaes, T, Klepstad, P, Olaussen, E, Olsen, K, Brresen, O, Bjorsvik, G, Maini, S, Fehrle, L, Czuczwar, M, Krawczyk, P, Zietkiewicz, M, Nowak, L, Kotfis, K, Cwyl, K, Gajdosz, R, Biernawska, J, Bohatyrewicz, R, Gawda, R, Grudzien, P, Nasilowski, P, Popek, N, Cyrankiewicz, W, Wawrzyniak, K, Wnuk, M, Maciejewski, D, Studzinska, D, Zukowski, M, Bernas, S, Piechota, M, Nowak, I, Fronczek, J, Serwa, M, Machala, W, Stefaniak, J, Wujtewicz, M, Maciejewski, P, Szymkowiak, M, Adamik, B, Catorze, N, 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, Rodriguez, E, Rebollo, S, Aguilar, G, Masdeu, G, Jaimes, M, Mira, A, Bodi, M, Mendoza, J, Cuenca, S, Guzman, M, Rico-Feijoo, J, Ibarz, M, Alvarez, J, Kawati, R, Sivik, J, Nauska, J, Smole, D, Parenmark, F, Lyren, J, Rockstroh, K, Ryden, S, 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, van Dijk, I, van Lelyveld-Haas, L, Ramnarain, D, Jansen, T, Nooteboom, F, van der Voort, P, Dieperink, W, de Waard, M, Bormans, L, Dormans, T, 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, 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, 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, Nalapko, Y, de Lange D. W., Brinkman S., Flaatten H., Boumendil A., Morandi A., Andersen F. H., Artigas A., Bertolini G., Cecconi M., Christensen S., Faraldi L., Fjolner J., Jung C., Marsh B., Moreno R., Oeyen S., Ohman C. A., Bollen Pinto B., de Smet A. M. G. A., Soliman I. W., Szczeklik W., Valentin A., Watson X., Zafeiridis T., Guidet B., Schmutz R., Wimmer F., Eller P., Joannidis M., De Buysscher P., De Neve N., Swinnen W., Abraham P., Hergafi L., Schefold Joerg. C., Biskup E., Piza P., Taliadoros I., Dey N., Solling C., Rasmussen B. S., 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., Lauten A., Sacher A. L., Brenner T., Franz M., Bloos F., Ebelt H., Schaller S. J., Fuest Kristina., Rabe C., Dieck T., Steiner S., Graf T., Nia A. M., Janosi R. A., Meybohm P., Simon P., Utzolino S., Rahmel T., Barth E., Schuster M., Aidoni Z., Aloizos S., Tasioudis P., Lampiri K., Zisopoulou V., Ravani I., Pagaki E., Antoniou A., Katsoulas T. A., Kounougeri A., Marinakis G., Tsimpoukas F., Spyropoulou A., Zygoulis P., Kyparissi A., Gupta M., Gurjar M., Maji I. M., Hayes I., Kelly Y., Westbrook A., Fitzpatrick G., Maheshwari D., Motherway C., Negri G., Spadaro S., Nattino G., Pedeferri M., Boscolo A., Rossi S., Calicchio G., Cubattoli L., Di Lascio G., Barbagallo M., Berruto F., Codazzi D., Bottazzi A., Fumagalli P., Negro G., Lupi G., Savelli F., Vulcano Giuseppe. A., 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., Adorni A., Bocci M. G., Cortegiani A., Casalicchio T., Mellea S., Graziani E., Barattini M., Brizio E., Rossi M., Hahn M., Kemmerer N., Strietzel H. F., Dybwik K., Legernaes T., Klepstad P., Olaussen E. B., Olsen K. I., Brresen O. M., Bjorsvik G., Maini S., Fehrle L., Czuczwar M., Krawczyk P., Zietkiewicz M., Nowak L. R., Kotfis K., Cwyl K., Gajdosz R., Biernawska J., Bohatyrewicz Romuald., Gawda R., Grudzien P., Nasilowski P., Popek N., Cyrankiewicz W., Wawrzyniak K., Wnuk M., Maciejewski D., Studzinska D., Zukowski M., Bernas S., Piechota M., Nowak I., Fronczek J., Serwa M., Machala W., Stefaniak J., Wujtewicz M., Maciejewski P., Szymkowiak M., Adamik B., Catorze N., Branco M. C., Barros I., Barros N., Krystopchuk A., Honrado T., Sousa C., Munoz F., Rebelo M., Gomes R., Nunes J., Dias Celeste., Fernandes A. M., Petrisor C., Constantin B., Belskiy V., Boskholov B., Rodriguez E., Rebollo S., Aguilar G., Masdeu G., Jaimes M. I., Mira A. P., Bodi Maria. A., Mendoza J. A. B., Cuenca S. L., Guzman M. H., Rico-Feijoo J., Ibarz M., Alvarez J. T., Kawati R., Sivik J., Nauska J., Smole D., Parenmark F., Lyren J., Rockstroh K., Ryden S., 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., van Dijk I., van Lelyveld-Haas L. E. M., Ramnarain D., Jansen T., Nooteboom F., van der Voort P. H. J., Dieperink W., de Waard M. C., Bormans L., Dormans Tom., Dempsey G., Mathew S. J., Raj A. S., 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., 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 Carmen., Donnison P., Shelton S., Frey C., Ryan C., Spray D., Barnes V., Barnes K., 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., Nalapko Y., de Lange, D, Brinkman, S, Flaatten, H, Boumendil, A, Morandi, A, Andersen, F, Artigas, A, Bertolini, G, Cecconi, M, Christensen, S, Faraldi, L, Fjolner, J, Jung, C, Marsh, B, Favarato, M, Oeyen, S, Ohman, C, Bollen Pinto, B, de Smet, A, Soliman, I, Szczeklik, W, Valentin, A, Watson, X, Zafeiridis, T, Guidet, B, Schmutz, R, Wimmer, F, Eller, P, Joannidis, M, De Buysscher, P, De Neve, N, Swinnen, W, Abraham, P, Hergafi, L, Schefold, J, Biskup, E, Piza, P, Taliadoros, I, Dey, N, Solling, C, Rasmussen, B, 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, 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, Aidoni, Z, Aloizos, S, Tasioudis, P, Lampiri, K, Zisopoulou, V, Ravani, I, Pagaki, E, Antoniou, A, Katsoulas, T, Kounougeri, A, Marinakis, G, Tsimpoukas, F, Spyropoulou, A, Zygoulis, P, Kyparissi, A, Gupta, M, Gurjar, M, Maji, I, Hayes, I, Kelly, Y, Westbrook, A, Fitzpatrick, G, Maheshwari, D, Motherway, C, Negri, G, Spadaro, S, Nattino, G, Pedeferri, M, Boscolo, A, Rossi, S, 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, Adorni, A, Bocci, M, Cortegiani, A, Casalicchio, T, Mellea, S, Graziani, E, Barattini, M, Brizio, E, Rossi, M, Hahn, M, Kemmerer, N, Strietzel, H, Dybwik, K, Legernaes, T, Klepstad, P, Olaussen, E, Olsen, K, Brresen, O, Bjorsvik, G, Maini, S, Fehrle, L, Czuczwar, M, Krawczyk, P, Zietkiewicz, M, Nowak, L, Kotfis, K, Cwyl, K, Gajdosz, R, Biernawska, J, Bohatyrewicz, R, Gawda, R, Grudzien, P, Nasilowski, P, Popek, N, Cyrankiewicz, W, Wawrzyniak, K, Wnuk, M, Maciejewski, D, Studzinska, D, Zukowski, M, Bernas, S, Piechota, M, Nowak, I, Fronczek, J, Serwa, M, Machala, W, Stefaniak, J, Wujtewicz, M, Maciejewski, P, Szymkowiak, M, Adamik, B, Catorze, N, 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, Rodriguez, E, Rebollo, S, Aguilar, G, Masdeu, G, Jaimes, M, Mira, A, Bodi, M, Mendoza, J, Cuenca, S, Guzman, M, Rico-Feijoo, J, Ibarz, M, Alvarez, J, Kawati, R, Sivik, J, Nauska, J, Smole, D, Parenmark, F, Lyren, J, Rockstroh, K, Ryden, S, 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, van Dijk, I, van Lelyveld-Haas, L, Ramnarain, D, Jansen, T, Nooteboom, F, van der Voort, P, Dieperink, W, de Waard, M, Bormans, L, Dormans, T, 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, 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, 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, Nalapko, Y, de Lange D. W., Brinkman S., Flaatten H., Boumendil A., Morandi A., Andersen F. H., Artigas A., Bertolini G., Cecconi M., Christensen S., Faraldi L., Fjolner J., Jung C., Marsh B., Moreno R., Oeyen S., Ohman C. A., Bollen Pinto B., de Smet A. M. G. A., Soliman I. W., Szczeklik W., Valentin A., Watson X., Zafeiridis T., Guidet B., Schmutz R., Wimmer F., Eller P., Joannidis M., De Buysscher P., De Neve N., Swinnen W., Abraham P., Hergafi L., Schefold Joerg. C., Biskup E., Piza P., Taliadoros I., Dey N., Solling C., Rasmussen B. S., 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., Lauten A., Sacher A. L., Brenner T., Franz M., Bloos F., Ebelt H., Schaller S. J., Fuest Kristina., Rabe C., Dieck T., Steiner S., Graf T., Nia A. M., Janosi R. A., Meybohm P., Simon P., Utzolino S., Rahmel T., Barth E., Schuster M., Aidoni Z., Aloizos S., Tasioudis P., Lampiri K., Zisopoulou V., Ravani I., Pagaki E., Antoniou A., Katsoulas T. A., Kounougeri A., Marinakis G., Tsimpoukas F., Spyropoulou A., Zygoulis P., Kyparissi A., Gupta M., Gurjar M., Maji I. M., Hayes I., Kelly Y., Westbrook A., Fitzpatrick G., Maheshwari D., Motherway C., Negri G., Spadaro S., Nattino G., Pedeferri M., Boscolo A., Rossi S., Calicchio G., Cubattoli L., Di Lascio G., Barbagallo M., Berruto F., Codazzi D., Bottazzi A., Fumagalli P., Negro G., Lupi G., Savelli F., Vulcano Giuseppe. A., 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., Adorni A., Bocci M. G., Cortegiani A., Casalicchio T., Mellea S., Graziani E., Barattini M., Brizio E., Rossi M., Hahn M., Kemmerer N., Strietzel H. F., Dybwik K., Legernaes T., Klepstad P., Olaussen E. B., Olsen K. I., Brresen O. M., Bjorsvik G., Maini S., Fehrle L., Czuczwar M., Krawczyk P., Zietkiewicz M., Nowak L. R., Kotfis K., Cwyl K., Gajdosz R., Biernawska J., Bohatyrewicz Romuald., Gawda R., Grudzien P., Nasilowski P., Popek N., Cyrankiewicz W., Wawrzyniak K., Wnuk M., Maciejewski D., Studzinska D., Zukowski M., Bernas S., Piechota M., Nowak I., Fronczek J., Serwa M., Machala W., Stefaniak J., Wujtewicz M., Maciejewski P., Szymkowiak M., Adamik B., Catorze N., Branco M. C., Barros I., Barros N., Krystopchuk A., Honrado T., Sousa C., Munoz F., Rebelo M., Gomes R., Nunes J., Dias Celeste., Fernandes A. M., Petrisor C., Constantin B., Belskiy V., Boskholov B., Rodriguez E., Rebollo S., Aguilar G., Masdeu G., Jaimes M. I., Mira A. P., Bodi Maria. A., Mendoza J. A. B., Cuenca S. L., Guzman M. H., Rico-Feijoo J., Ibarz M., Alvarez J. T., Kawati R., Sivik J., Nauska J., Smole D., Parenmark F., Lyren J., Rockstroh K., Ryden S., 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., van Dijk I., van Lelyveld-Haas L. E. M., Ramnarain D., Jansen T., Nooteboom F., van der Voort P. H. J., Dieperink W., de Waard M. C., Bormans L., Dormans Tom., Dempsey G., Mathew S. J., Raj A. S., 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., 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 Carmen., Donnison P., Shelton S., Frey C., Ryan C., Spray D., Barnes V., Barnes K., 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., and Nalapko Y.

Abstract

OBJECTIVES: To develop a scoring system model that predicts mortality within 30 days of admission of patients older than 80 years admitted to intensive care units (ICUs). DESIGN: Prospective cohort study. SETTING: A total of 306 ICUs from 24 European countries. PARTICIPANTS: Older adults admitted to European ICUs (N = 3730; median age = 84 years [interquartile range = 81-87 y]; 51.8% male). MEASUREMENTS: Overall, 24 variables available during ICU admission were included as potential predictive variables. Multivariable logistic regression was used to identify independent predictors of 30-day mortality. Model sensitivity, specificity, and accuracy were evaluated with receiver operating characteristic curves. RESULTS: The 30-day-mortality was 1562 (41.9%). In multivariable analysis, these variables were selected as independent predictors of mortality: age, sex, ICU admission diagnosis, Clinical Frailty Scale, Sequential Organ Failure Score, invasive mechanical ventilation, and renal replacement therapy. The discrimination, accuracy, and calibration of the model were good: the area under the curve for a score of 10 or higher was.80, and the Brier score was.18. At a cut point of 10 or higher (75% of all patients), the model predicts 30-day mortality in 91.1% of all patients who die. CONCLUSION: A predictive model of cumulative events predicts 30-day mortality in patients older than 80 years admitted to ICUs. Future studies should include other potential predictor variables including functional status, presence of advance care plans, and assessment of each patient's decision-making capacity.

Published
2019

7. Cumulative Prognostic Score Predicting Mortality in Patients Older Than 80 Years Admitted to the ICU

Author

de Lange D. W., Brinkman S., Flaatten H., Boumendil A., Morandi A., Andersen F. H., Artigas A., Bertolini G., Cecconi M., Christensen S., Faraldi L., Fjolner J., Jung C., Marsh B., Moreno R., Oeyen S., Ohman C. A., Bollen Pinto B., de Smet A. M. G. A., Soliman I. W., Szczeklik W., Valentin A., Watson X., Zafeiridis T., Guidet B., Schmutz R., Wimmer F., Eller P., Joannidis M., De Buysscher P., De Neve N., Swinnen W., Abraham P., Hergafi L., Schefold Joerg. C., Biskup E., Piza P., Taliadoros I., Dey N., Solling C., Rasmussen B. S., 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., Lauten A., Sacher A. L., Brenner T., Franz M., Bloos F., Ebelt H., Schaller S. J., Fuest Kristina., Rabe C., Dieck T., Steiner S., Graf T., Nia A. M., Janosi R. A., Meybohm P., Simon P., Utzolino S., Rahmel T., Barth E., Schuster M., Aidoni Z., Aloizos S., Tasioudis P., Lampiri K., Zisopoulou V., Ravani I., Pagaki E., Antoniou A., Katsoulas T. A., Kounougeri A., Marinakis G., Tsimpoukas F., Spyropoulou A., Zygoulis P., Kyparissi A., Gupta M., Gurjar M., Maji I. M., Hayes I., Kelly Y., Westbrook A., Fitzpatrick G., Maheshwari D., Motherway C., Negri G., Spadaro S., Nattino G., Pedeferri M., Boscolo A., Rossi S., Calicchio G., Cubattoli L., Di Lascio G., Barbagallo M., Berruto F., Codazzi D., Bottazzi A., Fumagalli P., Negro G., Lupi G., Savelli F., Vulcano Giuseppe. A., 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., Adorni A., Bocci M. G., Cortegiani A., Casalicchio T., Mellea S., Graziani E., Barattini M., Brizio E., Rossi M., Hahn M., Kemmerer N., Strietzel H. F., Dybwik K., Legernaes T., Klepstad P., Olaussen E. B., Olsen K. I., Brresen O. M., Bjorsvik G., Maini S., Fehrle L., Czuczwar M., Krawczyk P., Zietkiewicz M., Nowak L. R., Kotfis K., Cwyl K., Gajdosz R., Biernawska J., Bohatyrewicz Romuald., Gawda R., Grudzien P., Nasilowski P., Popek N., Cyrankiewicz W., Wawrzyniak K., Wnuk M., Maciejewski D., Studzinska D., Zukowski M., Bernas S., Piechota M., Nowak I., Fronczek J., Serwa M., Machala W., Stefaniak J., Wujtewicz M., Maciejewski P., Szymkowiak M., Adamik B., Catorze N., Branco M. C., Barros I., Barros N., Krystopchuk A., Honrado T., Sousa C., Munoz F., Rebelo M., Gomes R., Nunes J., Dias Celeste., Fernandes A. M., Petrisor C., Constantin B., Belskiy V., Boskholov B., Rodriguez E., Rebollo S., Aguilar G., Masdeu G., Jaimes M. I., Mira A. P., Bodi Maria. A., Mendoza J. A. B., Cuenca S. L., Guzman M. H., Rico-Feijoo J., Ibarz M., Alvarez J. T., Kawati R., Sivik J., Nauska J., Smole D., Parenmark F., Lyren J., Rockstroh K., Ryden S., 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., van Dijk I., van Lelyveld-Haas L. E. M., Ramnarain D., Jansen T., Nooteboom F., van der Voort P. H. J., Dieperink W., de Waard M. C., Bormans L., Dormans Tom., Dempsey G., Mathew S. J., Raj A. S., 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., 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 Carmen., Donnison P., Shelton S., Frey C., Ryan C., Spray D., Barnes V., Barnes K., 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., Nalapko Y., Microbes in Health and Disease (MHD), Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Medical Informatics, APH - Methodology, APH - Quality of Care, de Lange, D, Brinkman, S, Flaatten, H, Boumendil, A, Morandi, A, Andersen, F, Artigas, A, Bertolini, G, Cecconi, M, Christensen, S, Faraldi, L, Fjolner, J, Jung, C, Marsh, B, Favarato, M, Oeyen, S, Ohman, C, Bollen Pinto, B, de Smet, A, Soliman, I, Szczeklik, W, Valentin, A, Watson, X, Zafeiridis, T, Guidet, B, Schmutz, R, Wimmer, F, Eller, P, Joannidis, M, De Buysscher, P, De Neve, N, Swinnen, W, Abraham, P, Hergafi, L, Schefold, J, Biskup, E, Piza, P, Taliadoros, I, Dey, N, Solling, C, Rasmussen, B, 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, 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, Aidoni, Z, Aloizos, S, Tasioudis, P, Lampiri, K, Zisopoulou, V, Ravani, I, Pagaki, E, Antoniou, A, Katsoulas, T, Kounougeri, A, Marinakis, G, Tsimpoukas, F, Spyropoulou, A, Zygoulis, P, Kyparissi, A, Gupta, M, Gurjar, M, Maji, I, Hayes, I, Kelly, Y, Westbrook, A, Fitzpatrick, G, Maheshwari, D, Motherway, C, Negri, G, Spadaro, S, Nattino, G, Pedeferri, M, Boscolo, A, Rossi, S, 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, Adorni, A, Bocci, M, Cortegiani, A, Casalicchio, T, Mellea, S, Graziani, E, Barattini, M, Brizio, E, Rossi, M, Hahn, M, Kemmerer, N, Strietzel, H, Dybwik, K, Legernaes, T, Klepstad, P, Olaussen, E, Olsen, K, Brresen, O, Bjorsvik, G, Maini, S, Fehrle, L, Czuczwar, M, Krawczyk, P, Zietkiewicz, M, Nowak, L, Kotfis, K, Cwyl, K, Gajdosz, R, Biernawska, J, Bohatyrewicz, R, Gawda, R, Grudzien, P, Nasilowski, P, Popek, N, Cyrankiewicz, W, Wawrzyniak, K, Wnuk, M, Maciejewski, D, Studzinska, D, Zukowski, M, Bernas, S, Piechota, M, Nowak, I, Fronczek, J, Serwa, M, Machala, W, Stefaniak, J, Wujtewicz, M, Maciejewski, P, Szymkowiak, M, Adamik, B, Catorze, N, 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, Rodriguez, E, Rebollo, S, Aguilar, G, Masdeu, G, Jaimes, M, Mira, A, Bodi, M, Mendoza, J, Cuenca, S, Guzman, M, Rico-Feijoo, J, Ibarz, M, Alvarez, J, Kawati, R, Sivik, J, Nauska, J, Smole, D, Parenmark, F, Lyren, J, Rockstroh, K, Ryden, S, 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, van Dijk, I, van Lelyveld-Haas, L, Ramnarain, D, Jansen, T, Nooteboom, F, van der Voort, P, Dieperink, W, de Waard, M, Bormans, L, Dormans, T, 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, 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, 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, Nalapko, Y, de Lange D.W., Brinkman S., Flaatten H., Boumendil A., Morandi A., Andersen F.H., Artigas A., Bertolini G., Cecconi M., Christensen S., Faraldi L., Fjolner J., Jung C., Marsh B., Moreno R., Oeyen S., Ohman C.A., Bollen Pinto B., de Smet A.M.G.A., Soliman I.W., Szczeklik W., Valentin A., Watson X., Zafeiridis T., Guidet B., Schmutz R., Wimmer F., Eller P., Joannidis M., De Buysscher P., De Neve N., Swinnen W., Abraham P., Hergafi L., Schefold Joerg.C., Biskup E., Piza P., Taliadoros I., Dey N., Solling C., Rasmussen B.S., 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., Lauten A., Sacher A.L., Brenner T., Franz M., Bloos F., Ebelt H., Schaller S.J., Fuest Kristina., Rabe C., Dieck T., Steiner S., Graf T., Nia A.M., Janosi R.A., Meybohm P., Simon P., Utzolino S., Rahmel T., Barth E., Schuster M., Aidoni Z., Aloizos S., Tasioudis P., Lampiri K., Zisopoulou V., Ravani I., Pagaki E., Antoniou A., Katsoulas T.A., Kounougeri A., Marinakis G., Tsimpoukas F., Spyropoulou A., Zygoulis P., Kyparissi A., Gupta M., Gurjar M., Maji I.M., Hayes I., Kelly Y., Westbrook A., Fitzpatrick G., Maheshwari D., Motherway C., Negri G., Spadaro S., Nattino G., Pedeferri M., Boscolo A., Rossi S., Calicchio G., Cubattoli L., Di Lascio G., Barbagallo M., Berruto F., Codazzi D., Bottazzi A., Fumagalli P., Negro G., Lupi G., Savelli F., Vulcano Giuseppe.A., 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., Adorni A., Bocci M.G., Cortegiani A., Casalicchio T., Mellea S., Graziani E., Barattini M., Brizio E., Rossi M., Hahn M., Kemmerer N., Strietzel H.F., Dybwik K., Legernaes T., Klepstad P., Olaussen E.B., Olsen K.I., Brresen O.M., Bjorsvik G., Maini S., Fehrle L., Czuczwar M., Krawczyk P., Zietkiewicz M., Nowak L.R., Kotfis K., Cwyl K., Gajdosz R., Biernawska J., Bohatyrewicz Romuald., Gawda R., Grudzien P., Nasilowski P., Popek N., Cyrankiewicz W., Wawrzyniak K., Wnuk M., Maciejewski D., Studzinska D., Zukowski M., Bernas S., Piechota M., Nowak I., Fronczek J., Serwa M., Machala W., Stefaniak J., Wujtewicz M., Maciejewski P., Szymkowiak M., Adamik B., Catorze N., Branco M.C., Barros I., Barros N., Krystopchuk A., Honrado T., Sousa C., Munoz F., Rebelo M., Gomes R., Nunes J., Dias Celeste., Fernandes A.M., Petrisor C., Constantin B., Belskiy V., Boskholov B., Rodriguez E., Rebollo S., Aguilar G., Masdeu G., Jaimes M.I., Mira A.P., Bodi Maria.A., Mendoza J.A.B., Cuenca S.L., Guzman M.H., Rico-Feijoo J., Ibarz M., Alvarez J.T., Kawati R., Sivik J., Nauska J., Smole D., Parenmark F., Lyren J., Rockstroh K., Ryden S., 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., van Dijk I., van Lelyveld-Haas L.E.M., Ramnarain D., Jansen T., Nooteboom F., van der Voort P.H.J., Dieperink W., de Waard M.C., Bormans L., Dormans Tom., Dempsey G., Mathew S.J., Raj A.S., 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., 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 Carmen., Donnison P., Shelton S., Frey C., Ryan C., Spray D., Barnes V., Barnes K., 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., Nalapko Y., University Medical Center [Utrecht], University of Amsterdam [Amsterdam] (UvA), Public Health Service of Amsterdam, University of Bergen (UiB), Haukeland University Hospital, 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), Norwegian University of Science and Technology [Trondheim] (NTNU), Norwegian University of Science and Technology (NTNU), Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Universitat Autònoma de Barcelona (UAB), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aarhus University Hospital, Centro Hospitalar de Lisboa Central E.P.E, Ghent University Hospital, Karolinska University Hospital [Stockholm], Geneva University Hospital (HUG), University Medical Center Groningen [Groningen] (UMCG), Uniwersytet Jagielloński w Krakowie = Jagiellonian University (UJ), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), VIP1 Study Group (Beitragende*r), and Janosi, Rolf Alexander (Beitragende*r)

Subjects
Male, INTENSIVE-CARE-UNIT, Organ Dysfunction Scores, medicine.medical_treatment, Prognosis, Medizin, DECISION-MAKING, Logistic regression, law.invention, older adult, 0302 clinical medicine, PHYSICIANS, Interquartile range, law, 80 and over, Medicine and Health Sciences, 030212 general & internal medicine, Hospital Mortality, Prospective Studies, Prospective cohort study, older adults, Aged, 80 and over, predict, ddc:617, Respiration, [SDV.MHEP.GEG]Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, Brief Report, Intensive care unit, ADMISSION, 3. Good health, Europe, Hospitalization, Intensive Care Units, Brier score, Older adults, Artificial, Female, prognosi, medicine.medical_specialty, critical care, model, prognosis, Humans, Respiration, Artificial, 03 medical and health sciences, Intensive care, medicine, Journal Article, ILL ELDERLY-PATIENTS, Renal replacement therapy, Aged, Receiver operating characteristic, business.industry, 030208 emergency & critical care medicine, Emergency medicine, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Brief Reports, Geriatrics and Gerontology, business
Abstract

OBJECTIVES To develop a scoring system model that predicts mortality within 30 days of admission of patients older than 80 years admitted to intensive care units (ICUs). DESIGN Prospective cohort study. SETTING A total of 306 ICUs from 24 European countries. PARTICIPANTS Older adults admitted to European ICUs (N = 3730; median age = 84 years [interquartile range = 81‐87 y]; 51.8% male). MEASUREMENTS Overall, 24 variables available during ICU admission were included as potential predictive variables. Multivariable logistic regression was used to identify independent predictors of 30‐day mortality. Model sensitivity, specificity, and accuracy were evaluated with receiver operating characteristic curves. RESULTS The 30‐day‐mortality was 1562 (41.9%). In multivariable analysis, these variables were selected as independent predictors of mortality: age, sex, ICU admission diagnosis, Clinical Frailty Scale, Sequential Organ Failure Score, invasive mechanical ventilation, and renal replacement therapy. The discrimination, accuracy, and calibration of the model were good: the area under the curve for a score of 10 or higher was .80, and the Brier score was .18. At a cut point of 10 or higher (75% of all patients), the model predicts 30‐day mortality in 91.1% of all patients who die. CONCLUSION A predictive model of cumulative events predicts 30‐day mortality in patients older than 80 years admitted to ICUs. Future studies should include other potential predictor variables including functional status, presence of advance care plans, and assessment of each patient's decision‐making capacity. © 2019 The Authors. Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Published
2019

8. Relationship between the Clinical Frailty Scale and short-term mortality in patients ≥ 80 years old acutely admitted to the ICU: a prospective cohort study

Author

Fronczek, Jakub, Polok, Kamil, de Lange, Dylan W., Jung, Christian, Beil, Michael, Rhodes, Andrew, Fjølner, Jesper, Górka, Jacek, Andersen, Finn H., Artigas, Antonio, Cecconi, Maurizio, Christensen, Steffen, Joannidis, Michael, Leaver, Susannah, Marsh, Brian, Morandi, Alessandro, Moreno, Rui, Oeyen, Sandra, Agvald-Öhman, Christina, Bollen Pinto, Bernardo, Schefold, Joerg C., Valentin, Andreas, Walther, Sten, Watson, Ximena, Zafeiridis, Tilemachos, Sviri, Sigal, van Heerden, Peter Vernon, Flaatten, Hans, Guidet, Bertrand, Szczeklik, Wojciech, Schmutz, R., Wimmer, F., Eller, P., Joannidis, M., De Buysscher, P., De Neve, N., Oeyen, S., Swinnen, W., Bollen Pinto, B., Abraham, P., Hergafi, L., Schefold, J. C., Biskup, E., Piza, P., Taliadoros, I., Fjølner, J., Dey, N., Sølling, C., Rasmussen, B. S., Christensen, S., 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., Guidet, B., Charron, C., Lauten, A., Sacher, A. L., Brenner, T., Franz, M., Bloos, F., Ebelt, H., Schaller, S. J., Fuest, K., Rabe, C., Dieck, T., Steiner, S., Graf, T., Nia, A. M., Jung, C., Janosi, R. A., Meybohm, P., Simon, P., Utzolino, S., Rahmel, T., Barth, E., Schuster, M., Aidoni, Z., Aloizos, S., Tasioudis, P., Lampiri, K., Zisopoulou, V., Ravani, I., Pagaki, E., Antoniou, A., Katsoulas, T. A., Kounougeri, A., Marinakis, G., Tsimpoukas, F., Spyropoulou, A., Zygoulis, P., Kyparissi, A., Gupta, M., Gurjar, M., Maji, I. M., Hayes, I., Marsh, B., Kelly, Y., Westbrook, A., Fitzpatrick, G., Maheshwari, D., Motherway, C., Negri, G., Spadaro, S., Nattino, G., Pedeferri, M., Boscolo, A., Rossi, S., 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. A., 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., Adorni, A., Bocci, M. G., Cortegiani, A., Casalicchio, T., Mellea, S., Graziani, E., Barattini, M., Brizio, E., Rossi, M., Hahn, M., Flaatten, H., Kemmerer, N., Strietzel, H. F., Dybwik, K., Legernaes, T., Klepstad, P., Olaussen, E. B., Olsen, K. I., Brresen, O. M., Bjorsvik, G., Andersen, F. H., Maini, S., Fehrle, L., Czuczwar, M., Krawczyk, P., Ziętkiewicz, M., Nowak, Ł. R., Kotfis, K., Cwyl, K., Gajdosz, R., Biernawska, J., Bohatyrewicz, R., Gawda, R., Grudzień, P., Nasiłowski, P., Popek, N., Cyrankiewicz, W., Wawrzyniak, K., Wnuk, M., Maciejewski, D., Studzińska, D., Żukowski, M., Bernas, S., Piechota, M., Szczeklik, W., Nowak-Kózka, I., Fronczek, J., Serwa, M., Machała, W., Stefaniak, J., Wujtewicz, M., Maciejewski, P., Szymkowiak, M., Adamik, B., Polok, K., Górka, J., Catorze, N., Branco, M. C., Barros, N., Barros, I., Krystopchuk, A., Honrado, T., Sousa, C., Munoz, F., Rebelo, M., Gomes, R., Nunes, J., Dias, C., Fernandes, A. M., Petrisor, C., Constantin, B., Belskiy, V., Boskholov, B., Rodriguez, E., Aguilar, G., Masdeu, G., Jaimes, M. I., Mira, A. P., Bodi, M. A., Mendoza, J. A. B., López-Cuenca, S., Guzman, M. H., Rico-Feijoo, J., Ibarz, M., Alvarez, J. Trenado, Kawati, R., Sivik, J., Nauska, J., Smole, D., Parenmark, F., Lyrén, J., Rockstroh, K., Rydén, S., Spångfors, M., Strinnholm, M., Walther, S., De Geer, L., Nordlund, P., Pålsson, S., Zetterquist, H., Nilsson, A., Thiringer, K., Jungner, M., Bark, B., Nordling, B., Sköld, H., Brorsson, C., Persson, S., Bergström, A., Berkius, J., Holmström, J., van Dijk, I., van Lelyveld-Haas, L. E. M., Jansen, T., Nooteboom, F., van der Voort, P. H. J., de Lange, D., Dieperink, W., de Waard, M. C., de Smet, A. G. E., Bormans, L., Dormans, T., Dempsey, G., Mathew, S. J., Raj, A. S., Grecu, I., Cupitt, J., Lawton, T., Clark, R., Popescu, M., Spittle, N., Faulkner, M., Cowton, A., Williams, P., Elloway, E., 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., 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., 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., Nalapko, Y., Helbok, R., Nollet, J., de Neve, N., Mikačić, M., Bastiansen, A., Husted, A., Dahle, B. E. S., Cramer, C., Ørsnes, D., Thomsen, J. Edelberg, Pedersen, J. J., Enevoldsen, M. Hummelmose, Elkmann, T., Kubisz-Pudelko, A., Collins, A., Hart, C., Randell, G., Filipe, H., Welters, I. D., Evans, J., Lord, J., Jones, J., Ball, J., North, J., Salaunkey, K., De Gordoa, L. Ortiz-Ruiz, Bell, L., Vizcaychipi, M., Mupudzi, M., Lea-Hagerty, M., Spivey, M., Love, N., White, N., Morgan, P., Wakefield, P., Savine, R., Jacob, R., Innes, R., Rose, S., Leaver, S., Mane, T., Ogbeide, V., Baird, Y., Romen, A., Galbois, A., Vinsonneau, C., Thevenin, D., Guerot, E., Savary, G., Chagnon, J. L., Rigaud, J. P., Quenot, J. P., Castaneray, J., Rosman, J., Maizel, J., Tiercelet, K., Hovaere, M. M., Messika, M., Djibré, M., Rolin, N., Burtin, P., Garcon, P., Nseir, S., Valette, X., Horacek, M., Bruno, R. Romano, Allgäuer, S., Dubler, S., Schering, S., Koutsikou, A., Vakalos, A., Raitsiou, B., Flioni, E. N., Neou, E., Papathanakos, G., Koutsodimitropoulos, I., Aikaterini, K., Rovina, N., Kourelea, S., Polychronis, T., Zidianakis, V., Konstantinia, V., Read, C., Martin-Loeches, I., Cracchiolo, A. Neville, Morigi, A., Brusa, S., Elhadi, A., Tarek, A., Khaled, A., Ahmed, H., Belkhair, W. Ali, Cornet, A. D., Gommers, D., van Boven, E., Haringman, J., Haas, L., van den Berg, L., Hoiting, O., de Jager, P., Gerritsen, R. T., Breidablik, A., Slapgard, A., Rime, A. K., Jannestad, B., Sjøbøe, B., Rice, E., Jensen, J. P., Langørgen, J., Tøien, K., Strand, K., Biernacka, A., Kluzik, A., Kudlinski, B., Hymczak, H., Solek-Pastuszka, J., Zorska, J., Krzych, Ł. J., Zukowski, M., Lipińska-Gediga, M., Pietruszko, M., Kozera, N., Sendur, P., Zatorski, P., Galkin, P., Kościuczuk, U., Gola, W., Pinto, A. F., Santos, A. R., Ferreira, I. A., Blanco, J. B., Carvalho, J. T., Maia, J., Candeias, N., Lores, A., Cilloniz, C., Perez-Torres, D., Maseda, E., Prol-Silva, E., Eixarch, G., Gomà, G., Velasco, G. Navarro, Jaimes, M. Irazábal, Villamayor, M. Ibarz, Fernández, N. Llamas, Cubero, P. Jimeno, Tomasa, T., Sjöqvist, A., Schiöler, F., Westberg, H., Thiringer, K. Kleiven, Boroli, F., Eckert, P., Yıldız, I., Yovenko, I., for the VIP1, [missing], VIP2 study group, [missing], Fronczek, Jakub, Polok, Kamil, de Lange, Dylan W, Jung, Christian, Beil, Michael, Rhodes, Andrew, Fjølner, Jesper, Górka, Jacek, Andersen, Finn H, Artigas, Antonio, Cecconi, Maurizio, Christensen, Steffen, Joannidis, Michael, Leaver, Susannah, Marsh, Brian, Morandi, Alessandro, Moreno, Rui, Oeyen, Sandra, Agvald-Öhman, Christina, Bollen Pinto, Bernardo, Schefold, Joerg C, Valentin, Andrea, Walther, Sten, Watson, Ximena, Zafeiridis, Tilemacho, Sviri, Sigal, van Heerden, Peter Vernon, Flaatten, Han, Guidet, Bertrand, Szczeklik, Wojciech, R Schmutz, F Wimmer, P Eller, M Joannidis, P De Buysscher, N De Neve, S Oeyen, W Swinnen, B Bollen Pinto, P Abraham, L Hergafi, J C Schefold, E Biskup, P Piza, I Taliadoros, J Fjølner, N Dey, C Sølling, B S Rasmussen, S Christensen, X Forceville, G Besch, H Mentec, P Michel, P Mateu, P Michel, L Vettoretti, J Bourenne, N Marin, M Guillot, N Aissaoui, C Goulenok, N Thieulot-Rolin, J Messika, L Lamhaut, B Guidet, C Charron, A Lauten, A L Sacher, T Brenner, M Franz, F Bloos, H Ebelt, S J Schaller, K Fuest, C Rabe, T Dieck, S Steiner, T Graf, A M Nia, C Jung, R A Janosi, P Meybohm, P Simon, S Utzolino, T Rahmel, E Barth, C Jung, M Schuster, Z Aidoni, S Aloizos, P Tasioudis, K Lampiri, V Zisopoulou, I Ravani, E Pagaki, A Antoniou, T A Katsoulas, A Kounougeri, G Marinakis, F Tsimpoukas, A Spyropoulou, P Zygoulis, A Kyparissi, M Gupta, M Gurjar, I M Maji, I Hayes, B Marsh, Y Kelly, A Westbrook, G Fitzpatrick, D Maheshwari, C Motherway, G Negri, S Spadaro, G Nattino, M Pedeferri, A Boscolo, S Rossi, G Calicchio, L Cubattoli, G Di Lascio, M Barbagallo, F Berruto, D Codazzi, A Bottazzi, P Fumagalli, G Negro, G Lupi, F Savelli, G A Vulcano, R Fumagalli, A Marudi, U Lefons, R Lembo, M Babini, A Paggioro, V Parrini, M Zaccaria, S Clementi, C Gigliuto, F Facondini, S Pastorini, S Munaron, I Calamai, A Bocchi, A Adorni, M G Bocci, A Cortegiani, T Casalicchio, S Mellea, E Graziani, M Barattini, E Brizio, M Rossi, M Hahn, H Flaatten, N Kemmerer, H F Strietzel, K Dybwik, T Legernaes, P Klepstad, E B Olaussen, K I Olsen, O M Brresen, G Bjorsvik, F H Andersen, S Maini, L Fehrle, M Czuczwar, P Krawczyk, M Ziętkiewicz, Ł R Nowak, K Kotfis, K Cwyl, R Gajdosz, J Biernawska, R Bohatyrewicz, R Gawda, P Grudzień, P Nasiłowski, N Popek, W Cyrankiewicz, K Wawrzyniak, M Wnuk, D Maciejewski, D Studzińska, M Żukowski, S Bernas, M Piechota, W Szczeklik, I Nowak-Kózka, J Fronczek, M Serwa, W Machała, J Stefaniak, M Wujtewicz, P Maciejewski, M Szymkowiak, B Adamik, K Polok, J Górka, N Catorze, M C Branco, N Barros, I Barros, A Krystopchuk, T Honrado, C Sousa, F Munoz, M Rebelo, R Gomes, J Nunes, C Dias, A M Fernandes, C Petrisor, B Constantin, V Belskiy, B Boskholov, E Rodriguez, G Aguilar, G Masdeu, M I Jaimes, A P Mira, M A Bodi, J A B Mendoza, S López-Cuenca, M H Guzman, J Rico-Feijoo, M Ibarz, J Trenado Alvarez, R Kawati, J Sivik, J Nauska, D Smole, F Parenmark, J Lyrén, K Rockstroh, S Rydén, M Spångfors, M Strinnholm, S Walther, L De Geer, P Nordlund, S Pålsson, H Zetterquist, A Nilsson, K Thiringer, M Jungner, B Bark, B Nordling, H Sköld, C Brorsson, S Persson, A Bergström, J Berkius, J Holmström, I van Dijk, L E M van Lelyveld-Haas, T Jansen, F Nooteboom, P H J van der Voort, D de Lange, W Dieperink, M C de Waard, A G E de Smet, L Bormans, T Dormans, G Dempsey, S J Mathew, A S Raj, I Grecu, J Cupitt, T Lawton, R Clark, M Popescu, N Spittle, M Faulkner, A Cowton, P Williams, E Elloway, M Reay, S Chukkambotla, R Kumar, N Al-Subaie, L Kent, T Tamm, I Kajtor, K Burns, R Pugh, M Ostermann, E Kam, H Bowyer, N Smith, M Templeton, J Henning, K Goffin, R Kapoor, S Laha, P Chilton, W Khaliq, A Crayford, S Coetzee, M Tait, W Stoker, M Gimenez, A Pope, J Camsooksai, D Pogson, K Quigley, J Ritzema, A Hormis, C Boulanger, M Balasubramaniam, L Vamplew, K Burt, D Martin, I Grecu, J Craig, J Prowle, N Doyle, J Shelton, C Scott, P Donnison, S Shelton, C Frey, C Ryan, D Spray, C Ryan, V Barnes, K Barnes, S Ridgway, R Saha, L Kent, T Clark, J Wood, C Bolger, C Bassford, A Cowton, J Lewandowski, X Zhao, S Humphreys, S Dowling, N Richardson, A Burtenshaw, C Stevenson, D Wilcock, Y Nalapko, M Joannidis, P Eller, R Helbok, R Schmutz, J Nollet, N de Neve, P De Buysscher, S Oeyen, W Swinnen, M Mikačić, A Bastiansen, A Husted, B E S Dahle, C Cramer, C Sølling, D Ørsnes, J Edelberg Thomsen, J J Pedersen, M Hummelmose Enevoldsen, T Elkmann, A Kubisz-Pudelko, A Pope, A Collins, A S Raj, C Boulanger, C Frey, C Hart, C Bolger, D Spray, G Randell, H Filipe, I D Welters, I Grecu, J Evans, J Cupitt, J Lord, J Henning, J Jones, J Ball, J North, K Salaunkey, L Ortiz-Ruiz De Gordoa, L Bell, M Balasubramaniam, M Vizcaychipi, M Faulkner, M Mupudzi, M Lea-Hagerty, M Reay, M Spivey, N Love, N Spittle, N White, P Williams, P Morgan, P Wakefield, R Savine, R Jacob, R Innes, R Kapoor, S Humphreys, S Rose, S Dowling, S Leaver, T Mane, T Lawton, V Ogbeide, W Khaliq, Y Baird, A Romen, A Galbois, B Guidet, C Vinsonneau, C Charron, D Thevenin, E Guerot, G Besch, G Savary, H Mentec, J L Chagnon, J P Rigaud, J P Quenot, J Castaneray, J Rosman, J Maizel, K Tiercelet, L Vettoretti, M M Hovaere, M Messika, M Djibré, N Rolin, P Burtin, P Garcon, S Nseir, X Valette, C Rabe, E Barth, H Ebelt, K Fuest, M Franz, M Horacek, M Schuster, P Meybohm, R Romano Bruno, S Allgäuer, S Dubler, S J Schaller, S Schering, S Steiner, T Dieck, T Rahmel, T Graf, A Koutsikou, A Vakalos, B Raitsiou, E N Flioni, E Neou, F Tsimpoukas, G Papathanakos, G Marinakis, I Koutsodimitropoulos, K Aikaterini, N Rovina, S Kourelea, T Polychronis, V Zidianakis, V Konstantinia, Z Aidoni, B Marsh, C Motherway, C Read, I Martin-Loeches, A Neville Cracchiolo, A Morigi, I Calamai, S Brusa, A Elhadi, A Tarek, A Khaled, H Ahmed, W Ali Belkhair, A D Cornet, D Gommers, D de Lange, E van Boven, J Haringman, L Haas, L van den Berg, O Hoiting, P de Jager, R T Gerritsen, T Dormans, W Dieperink, A Breidablik, A Slapgard, A K Rime, B Jannestad, B Sjøbøe, E Rice, F H Andersen, H F Strietzel, J P Jensen, J Langørgen, K Tøien, K Strand, M Hahn, P Klepstad, A Biernacka, A Kluzik, B Kudlinski, D Maciejewski, D Studzińska, H Hymczak, J Stefaniak, J Solek-Pastuszka, J Zorska, K Cwyl, Ł J Krzych, M Zukowski, M Lipińska-Gediga, M Pietruszko, M Piechota, M Serwa, M Czuczwar, M Ziętkiewicz, N Kozera, P Nasiłowski, P Sendur, P Zatorski, P Galkin, R Gawda, U Kościuczuk, W Cyrankiewicz, W Gola, A F Pinto, A M Fernandes, A R Santos, C Sousa, I Barros, I A Ferreira, J B Blanco, J T Carvalho, J Maia, N Candeias, N Catorze, V Belskiy, A Lores, A P Mira, C Cilloniz, D Perez-Torres, E Maseda, E Rodriguez, E Prol-Silva, G Eixarch, G Gomà, G Aguilar, G Navarro Velasco, M Irazábal Jaimes, M Ibarz Villamayor, N Llamas Fernández, P Jimeno Cubero, S López-Cuenca, T Tomasa, A Sjöqvist, C Brorsson, F Schiöler, H Westberg, J Nauska, J Sivik, J Berkius, K Kleiven Thiringer, L De Geer, S Walther, F Boroli, J C Schefold, L Hergafi, P Eckert, I Yıldız, I Yovenko, Y Nalapko, R Pugh, and Critical Care

Subjects
Male, Short term mortality, Critical Care and Intensive Care Medicine, Cohort Studies, 0302 clinical medicine, kwetsbaarheid, Medicine and Health Sciences, 80 and over, Medicine, 610 Medicine & health, Prospective cohort study, Correlation of Data, 11 Medical and Health Sciences, Aged, 80 and over, OUTCOMES, Intensive care units, Frailty, VIP1, Aged,&nbsp, Medical emergencies. Critical care. Intensive care. First aid, Scale (social sciences), Female, prospectief onderzoek, Life Sciences & Biomedicine, CRITICALLY-ILL PATIENTS, Study groups, medicine.medical_specialty, Anestesi och intensivvård, 80 jaar en ouder, INTENSIVE-CARE, BED AVAILABILITY, NO, 03 medical and health sciences, Critical Care Medicine, Intensive care, sterfte, General & Internal Medicine, Humans, Aged, Prospective studies, Mortality, In patient, ddc:610, Intensive Care Units, Logistic Models, Prospective Studies, Science & Technology, Anesthesiology and Intensive Care, business.industry, RC86-88.9, Research, 030208 emergency & critical care medicine, ADULTS, Aged, 80 and over, Emergency & Critical Care Medicine, 030228 respiratory system, intensivecareafdelingen, Critical illness, Emergency medicine, VIP2 study group, &nbsp, CRITICAL ILLNESS, business
Abstract

Background The Clinical Frailty Scale (CFS) is frequently used to measure frailty in critically ill adults. There is wide variation in the approach to analysing the relationship between the CFS score and mortality after admission to the ICU. This study aimed to evaluate the influence of modelling approach on the association between the CFS score and short-term mortality and quantify the prognostic value of frailty in this context. Methods We analysed data from two multicentre prospective cohort studies which enrolled intensive care unit patients ≥ 80 years old in 26 countries. The primary outcome was mortality within 30-days from admission to the ICU. Logistic regression models for both ICU and 30-day mortality included the CFS score as either a categorical, continuous or dichotomous variable and were adjusted for patient’s age, sex, reason for admission to the ICU, and admission Sequential Organ Failure Assessment score. Results The median age in the sample of 7487 consecutive patients was 84 years (IQR 81–87). The highest fraction of new prognostic information from frailty in the context of 30-day mortality was observed when the CFS score was treated as either a categorical variable using all original levels of frailty or a nonlinear continuous variable and was equal to 9% using these modelling approaches (p p Conclusion Knowledge about a patient’s frailty status adds a substantial amount of new prognostic information at the moment of admission to the ICU. Arbitrary simplification of the CFS score into fewer groups than originally intended leads to a loss of information and should be avoided. Trial registration NCT03134807 (VIP1), NCT03370692 (VIP2)

Published
2021

9. Correction to: Withholding or withdrawing of life-sustaining therapy in older adults (≥ 80 years) admitted to the intensive care unit (Intensive Care Medicine, (2018), 44, 7, (1027-1038), 10.1007/s00134-018-5196-7)

Author

Guidet B., Flaatten H., Boumendil A., Morandi A., Andersen F. H., Artigas A., Bertolini G., Cecconi M., Christensen S., Faraldi L., Fjolner J., Jung C., Marsh B., Moreno R., Oeyen S., Ohman C. A., Pinto B. B., Soliman I. W., Szczeklik W., Valentin A., Watson X., Zafeiridis T., De Lange D. W., Schmutz R., Wimmer F., Eller P., Zotter K., De Buysscher P., De Neve N., Swinnen W., Taliadoros I., Piza P., Dey N., Solling C., Rasmussen B. S., 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., Lauten A., Sacher A. L., Brenner T., Franz M., Bloos F., Ebelt H., Schaller S. J., Fuest K., Rabe C., Dieck T., Steiner S., Graf T., Nia A. M., Janosi R. A., Simon P., Utzolino S., Rahmel T., Barth E., Schuster M., Meybohm P., Aidoni Z., Aloizos S., Tasioudis P., Lampiri K., Zisopoulou V., Ravani I., Pagaki E., Antoniou A., Katsoulas T. A., Kounougeri A., Marinakis G., Tsimpoukas F., Spyropoulou A., Zygoulis P., Kyparissi A., Gupta M., Gurjar M., Maji I. M., Hayes I., Kelly Y., Westbrook A., Fitzpatrick G., Maheshwari D., Motherway C., Negri G., Spadaro S., Nattino G., Pedeferri M., Boscolo A., Rossi S., 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. A., 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., Adorni A., Bocci M. G., Cortegiani A., Casalicchio T., Mellea S., Graziani E., Barattini M., Brizio E., Rossi M., Hahn M., Kemmerer N., Strietzel H. F., Dybwik K., Legernaes T., Klepstad P., Olaussen E. B., Olsen K. I., Brresen O. M., Bjorsvik G., Maini S., Fehrle L., Czuczwar M., Krawczyk P., Zietkiewicz M., Nowak L. R., Kotfis K., Cwyl K., Gajdosz R., Biernawska J., Bohatyrewicz R., Gawda R., Grudzien P., Nasilowski P., Popek N., Cyrankiewicz W., Wawrzyniak K., Wnuk M., Maciejewski D., Studzinska D., Zukowski M., Bernas S., Piechota M., Nowak I., Fronczek J., Serwa M., Machala W., Stefaniak J., Wujtewicz M., Maciejewski P., Szymkowiak M., Adamik B., Catorze N., Branco M. C., Barros I., Barros N., Krystopchuk A., Honrado T., Sousa C., Munoz F., Rebelo M., Gomes R., Nunes J., dias C., Fernandes A. M., Petrisor C., Constantin B., Belskiy V., Boskholov B., Rodriguez E., Rebollo S., Aguilar G., Masdeu G., Jaimes M. I., Mira A. P., Bodi M. A., Barea Mendoza J. A., Lopez-Cuenca S., Guzman M. H., Rico-Feijoo J., Ibarz M., Alvarez J. T., 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., Abraham P., Hergafi L., Schefold J. C., Biskup E., van Dijk I., van Lelyveld-Haas L. E. M., Ramnarain D., Jansen T., Nooteboom F., van der Voort P. H. J., de Lange D., Dieperink W., de Waard M. C., de Smet A. G., Bormans L., Dormans T., Dempsey G., Mathew S. J., Raj A. S., 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., 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., 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., Nalapko Y., Guidet, B, Flaatten, H, Boumendil, A, Morandi, A, Andersen, F, Artigas, A, Bertolini, G, 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, Zafeiridis, T, De Lange, D, Schmutz, R, Wimmer, F, Eller, P, Zotter, K, De Buysscher, P, De Neve, N, Swinnen, W, Taliadoros, I, Piza, P, Dey, N, Solling, C, Rasmussen, B, 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, 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, Simon, P, Utzolino, S, Rahmel, T, Barth, E, Schuster, M, Meybohm, P, Aidoni, Z, Aloizos, S, Tasioudis, P, Lampiri, K, Zisopoulou, V, Ravani, I, Pagaki, E, Antoniou, A, Katsoulas, T, Kounougeri, A, Marinakis, G, Tsimpoukas, F, Spyropoulou, A, Zygoulis, P, Kyparissi, A, Gupta, M, Gurjar, M, Maji, I, Hayes, I, Kelly, Y, Westbrook, A, Fitzpatrick, G, Maheshwari, D, Motherway, C, Negri, G, Spadaro, S, Nattino, G, Pedeferri, M, Boscolo, A, Rossi, S, 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, Adorni, A, Bocci, M, Cortegiani, A, Casalicchio, T, Mellea, S, Graziani, E, Barattini, M, Brizio, E, Rossi, M, Hahn, M, Kemmerer, N, Strietzel, H, Dybwik, K, Legernaes, T, Klepstad, P, Olaussen, E, Olsen, K, Brresen, O, Bjorsvik, G, Maini, S, Fehrle, L, Czuczwar, M, Krawczyk, P, Zietkiewicz, M, Nowak, L, Kotfis, K, Cwyl, K, Gajdosz, R, Biernawska, J, Bohatyrewicz, R, Gawda, R, Grudzien, P, Nasilowski, P, Popek, N, Cyrankiewicz, W, Wawrzyniak, K, Wnuk, M, Maciejewski, D, Studzinska, D, Zukowski, M, Bernas, S, Piechota, M, Nowak, I, Fronczek, J, Serwa, M, Machala, W, Stefaniak, J, Wujtewicz, M, Maciejewski, P, Szymkowiak, M, Adamik, B, Catorze, N, 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, Rodriguez, E, Rebollo, S, Aguilar, G, Masdeu, G, Jaimes, M, Mira, A, Bodi, M, Barea Mendoza, J, Lopez-Cuenca, S, Guzman, M, Rico-Feijoo, J, Ibarz, M, Alvarez, J, 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, Abraham, P, Hergafi, L, Schefold, J, Biskup, E, van Dijk, I, van Lelyveld-Haas, L, Ramnarain, D, Jansen, T, Nooteboom, F, van der Voort, P, de Lange, D, Dieperink, W, de Waard, M, de Smet, A, Bormans, L, Dormans, T, 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, 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, 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, Nalapko, Y, Guidet B., Flaatten H., Boumendil A., Morandi A., Andersen F.H., Artigas A., Bertolini G., Cecconi M., Christensen S., Faraldi L., Fjolner J., Jung C., Marsh B., Moreno R., Oeyen S., Ohman C.A., Pinto B.B., Soliman I.W., Szczeklik W., Valentin A., Watson X., Zafeiridis T., De Lange D.W., Schmutz R., Wimmer F., Eller P., Zotter K., De Buysscher P., De Neve N., Swinnen W., Taliadoros I., Piza P., Dey N., Solling C., Rasmussen B.S., 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., Lauten A., Sacher A.L., Brenner T., Franz M., Bloos F., Ebelt H., Schaller S.J., Fuest K., Rabe C., Dieck T., Steiner S., Graf T., Nia A.M., Janosi R.A., Simon P., Utzolino S., Rahmel T., Barth E., Schuster M., Meybohm P., Aidoni Z., Aloizos S., Tasioudis P., Lampiri K., Zisopoulou V., Ravani I., Pagaki E., Antoniou A., Katsoulas T.A., Kounougeri A., Marinakis G., Tsimpoukas F., Spyropoulou A., Zygoulis P., Kyparissi A., Gupta M., Gurjar M., Maji I.M., Hayes I., Kelly Y., Westbrook A., Fitzpatrick G., Maheshwari D., Motherway C., Negri G., Spadaro S., Nattino G., Pedeferri M., Boscolo A., Rossi S., 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.A., 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., Adorni A., Bocci M.G., Cortegiani A., Casalicchio T., Mellea S., Graziani E., Barattini M., Brizio E., Rossi M., Hahn M., Kemmerer N., Strietzel H.F., Dybwik K., Legernaes T., Klepstad P., Olaussen E.B., Olsen K.I., Brresen O.M., Bjorsvik G., Maini S., Fehrle L., Czuczwar M., Krawczyk P., Zietkiewicz M., Nowak L.R., Kotfis K., Cwyl K., Gajdosz R., Biernawska J., Bohatyrewicz R., Gawda R., Grudzien P., Nasilowski P., Popek N., Cyrankiewicz W., Wawrzyniak K., Wnuk M., Maciejewski D., Studzinska D., Zukowski M., Bernas S., Piechota M., Nowak I., Fronczek J., Serwa M., Machala W., Stefaniak J., Wujtewicz M., Maciejewski P., Szymkowiak M., Adamik B., Catorze N., Branco M.C., Barros I., Barros N., Krystopchuk A., Honrado T., Sousa C., Munoz F., Rebelo M., Gomes R., Nunes J., dias C., Fernandes A.M., Petrisor C., Constantin B., Belskiy V., Boskholov B., Rodriguez E., Rebollo S., Aguilar G., Masdeu G., Jaimes M.I., Mira A.P., Bodi M.A., Barea Mendoza J.A., Lopez-Cuenca S., Guzman M.H., Rico-Feijoo J., Ibarz M., Alvarez J.T., 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., Abraham P., Hergafi L., Schefold J.C., Biskup E., van Dijk I., van Lelyveld-Haas L.E.M., Ramnarain D., Jansen T., Nooteboom F., van der Voort P.H.J., de Lange D., Dieperink W., de Waard M.C., de Smet A.G., Bormans L., Dormans T., Dempsey G., Mathew S.J., Raj A.S., 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., 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., 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., and Nalapko Y.

Subjects
End of life, ICU, withdrawing
Abstract

In the original publication Dr Patrick Meybohm of the Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Frankfurt University Hospital, Frankfurt, Germany was inadvertently omitted from the list of investigators.

Published
2018

10. Correction to: Withholding or withdrawing of life-sustaining therapy in older adults (≥ 80 years) admitted to the intensive care unit (Intensive Care Medicine, (2018), 44, 7, (1027-1038), 10.1007/s00134-018-5196-7)

Author

Guidet, B, Flaatten, H, Boumendil, A, Morandi, A, Andersen, F, Artigas, A, Bertolini, G, 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, Zafeiridis, T, De Lange, D, Schmutz, R, Wimmer, F, Eller, P, Zotter, K, De Buysscher, P, De Neve, N, Swinnen, W, Taliadoros, I, Piza, P, Dey, N, Solling, C, Rasmussen, B, 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, 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, Simon, P, Utzolino, S, Rahmel, T, Barth, E, Schuster, M, Meybohm, P, Aidoni, Z, Aloizos, S, Tasioudis, P, Lampiri, K, Zisopoulou, V, Ravani, I, Pagaki, E, Antoniou, A, Katsoulas, T, Kounougeri, A, Marinakis, G, Tsimpoukas, F, Spyropoulou, A, Zygoulis, P, Kyparissi, A, Gupta, M, Gurjar, M, Maji, I, Hayes, I, Kelly, Y, Westbrook, A, Fitzpatrick, G, Maheshwari, D, Motherway, C, Negri, G, Spadaro, S, Nattino, G, Pedeferri, M, Boscolo, A, Rossi, S, 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, Adorni, A, Bocci, M, Cortegiani, A, Casalicchio, T, Mellea, S, Graziani, E, Barattini, M, Brizio, E, Rossi, M, Hahn, M, Kemmerer, N, Strietzel, H, Dybwik, K, Legernaes, T, Klepstad, P, Olaussen, E, Olsen, K, Brresen, O, Bjorsvik, G, Maini, S, Fehrle, L, Czuczwar, M, Krawczyk, P, Zietkiewicz, M, Nowak, L, Kotfis, K, Cwyl, K, Gajdosz, R, Biernawska, J, Bohatyrewicz, R, Gawda, R, Grudzien, P, Nasilowski, P, Popek, N, Cyrankiewicz, W, Wawrzyniak, K, Wnuk, M, Maciejewski, D, Studzinska, D, Zukowski, M, Bernas, S, Piechota, M, Nowak, I, Fronczek, J, Serwa, M, Machala, W, Stefaniak, J, Wujtewicz, M, Maciejewski, P, Szymkowiak, M, Adamik, B, Catorze, N, 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, Rodriguez, E, Rebollo, S, Aguilar, G, Masdeu, G, Jaimes, M, Mira, A, Bodi, M, Barea Mendoza, J, Lopez-Cuenca, S, Guzman, M, Rico-Feijoo, J, Ibarz, M, Alvarez, J, 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, Abraham, P, Hergafi, L, Schefold, J, Biskup, E, van Dijk, I, van Lelyveld-Haas, L, Ramnarain, D, Jansen, T, Nooteboom, F, van der Voort, P, de Lange, D, Dieperink, W, de Waard, M, de Smet, A, Bormans, L, Dormans, T, 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, 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, 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, Nalapko, Y, Guidet B., Flaatten H., Boumendil A., Morandi A., Andersen F. H., Artigas A., Bertolini G., Cecconi M., Christensen S., Faraldi L., Fjolner J., Jung C., Marsh B., Moreno R., Oeyen S., Ohman C. A., Pinto B. B., Soliman I. W., Szczeklik W., Valentin A., Watson X., Zafeiridis T., De Lange D. W., Schmutz R., Wimmer F., Eller P., Zotter K., De Buysscher P., De Neve N., Swinnen W., Taliadoros I., Piza P., Dey N., Solling C., Rasmussen B. S., 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., Lauten A., Sacher A. L., Brenner T., Franz M., Bloos F., Ebelt H., Schaller S. J., Fuest K., Rabe C., Dieck T., Steiner S., Graf T., Nia A. M., Janosi R. A., Simon P., Utzolino S., Rahmel T., Barth E., Schuster M., Meybohm P., Aidoni Z., Aloizos S., Tasioudis P., Lampiri K., Zisopoulou V., Ravani I., Pagaki E., Antoniou A., Katsoulas T. A., Kounougeri A., Marinakis G., Tsimpoukas F., Spyropoulou A., Zygoulis P., Kyparissi A., Gupta M., Gurjar M., Maji I. M., Hayes I., Kelly Y., Westbrook A., Fitzpatrick G., Maheshwari D., Motherway C., Negri G., Spadaro S., Nattino G., Pedeferri M., Boscolo A., Rossi S., 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. A., 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., Adorni A., Bocci M. G., Cortegiani A., Casalicchio T., Mellea S., Graziani E., Barattini M., Brizio E., Rossi M., Hahn M., Kemmerer N., Strietzel H. F., Dybwik K., Legernaes T., Klepstad P., Olaussen E. B., Olsen K. I., Brresen O. M., Bjorsvik G., Maini S., Fehrle L., Czuczwar M., Krawczyk P., Zietkiewicz M., Nowak L. R., Kotfis K., Cwyl K., Gajdosz R., Biernawska J., Bohatyrewicz R., Gawda R., Grudzien P., Nasilowski P., Popek N., Cyrankiewicz W., Wawrzyniak K., Wnuk M., Maciejewski D., Studzinska D., Zukowski M., Bernas S., Piechota M., Nowak I., Fronczek J., Serwa M., Machala W., Stefaniak J., Wujtewicz M., Maciejewski P., Szymkowiak M., Adamik B., Catorze N., Branco M. C., Barros I., Barros N., Krystopchuk A., Honrado T., Sousa C., Munoz F., Rebelo M., Gomes R., Nunes J., dias C., Fernandes A. M., Petrisor C., Constantin B., Belskiy V., Boskholov B., Rodriguez E., Rebollo S., Aguilar G., Masdeu G., Jaimes M. I., Mira A. P., Bodi M. A., Barea Mendoza J. A., Lopez-Cuenca S., Guzman M. H., Rico-Feijoo J., Ibarz M., Alvarez J. T., 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., Abraham P., Hergafi L., Schefold J. C., Biskup E., van Dijk I., van Lelyveld-Haas L. E. M., Ramnarain D., Jansen T., Nooteboom F., van der Voort P. H. J., de Lange D., Dieperink W., de Waard M. C., de Smet A. G., Bormans L., Dormans T., Dempsey G., Mathew S. J., Raj A. S., 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., 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., 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., Nalapko Y., Guidet, B, Flaatten, H, Boumendil, A, Morandi, A, Andersen, F, Artigas, A, Bertolini, G, 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, Zafeiridis, T, De Lange, D, Schmutz, R, Wimmer, F, Eller, P, Zotter, K, De Buysscher, P, De Neve, N, Swinnen, W, Taliadoros, I, Piza, P, Dey, N, Solling, C, Rasmussen, B, 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, 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, Simon, P, Utzolino, S, Rahmel, T, Barth, E, Schuster, M, Meybohm, P, Aidoni, Z, Aloizos, S, Tasioudis, P, Lampiri, K, Zisopoulou, V, Ravani, I, Pagaki, E, Antoniou, A, Katsoulas, T, Kounougeri, A, Marinakis, G, Tsimpoukas, F, Spyropoulou, A, Zygoulis, P, Kyparissi, A, Gupta, M, Gurjar, M, Maji, I, Hayes, I, Kelly, Y, Westbrook, A, Fitzpatrick, G, Maheshwari, D, Motherway, C, Negri, G, Spadaro, S, Nattino, G, Pedeferri, M, Boscolo, A, Rossi, S, 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, Adorni, A, Bocci, M, Cortegiani, A, Casalicchio, T, Mellea, S, Graziani, E, Barattini, M, Brizio, E, Rossi, M, Hahn, M, Kemmerer, N, Strietzel, H, Dybwik, K, Legernaes, T, Klepstad, P, Olaussen, E, Olsen, K, Brresen, O, Bjorsvik, G, Maini, S, Fehrle, L, Czuczwar, M, Krawczyk, P, Zietkiewicz, M, Nowak, L, Kotfis, K, Cwyl, K, Gajdosz, R, Biernawska, J, Bohatyrewicz, R, Gawda, R, Grudzien, P, Nasilowski, P, Popek, N, Cyrankiewicz, W, Wawrzyniak, K, Wnuk, M, Maciejewski, D, Studzinska, D, Zukowski, M, Bernas, S, Piechota, M, Nowak, I, Fronczek, J, Serwa, M, Machala, W, Stefaniak, J, Wujtewicz, M, Maciejewski, P, Szymkowiak, M, Adamik, B, Catorze, N, 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, Rodriguez, E, Rebollo, S, Aguilar, G, Masdeu, G, Jaimes, M, Mira, A, Bodi, M, Barea Mendoza, J, Lopez-Cuenca, S, Guzman, M, Rico-Feijoo, J, Ibarz, M, Alvarez, J, 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, Abraham, P, Hergafi, L, Schefold, J, Biskup, E, van Dijk, I, van Lelyveld-Haas, L, Ramnarain, D, Jansen, T, Nooteboom, F, van der Voort, P, de Lange, D, Dieperink, W, de Waard, M, de Smet, A, Bormans, L, Dormans, T, 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, 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, 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, Nalapko, Y, Guidet B., Flaatten H., Boumendil A., Morandi A., Andersen F. H., Artigas A., Bertolini G., Cecconi M., Christensen S., Faraldi L., Fjolner J., Jung C., Marsh B., Moreno R., Oeyen S., Ohman C. A., Pinto B. B., Soliman I. W., Szczeklik W., Valentin A., Watson X., Zafeiridis T., De Lange D. W., Schmutz R., Wimmer F., Eller P., Zotter K., De Buysscher P., De Neve N., Swinnen W., Taliadoros I., Piza P., Dey N., Solling C., Rasmussen B. S., 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., Lauten A., Sacher A. L., Brenner T., Franz M., Bloos F., Ebelt H., Schaller S. J., Fuest K., Rabe C., Dieck T., Steiner S., Graf T., Nia A. M., Janosi R. A., Simon P., Utzolino S., Rahmel T., Barth E., Schuster M., Meybohm P., Aidoni Z., Aloizos S., Tasioudis P., Lampiri K., Zisopoulou V., Ravani I., Pagaki E., Antoniou A., Katsoulas T. A., Kounougeri A., Marinakis G., Tsimpoukas F., Spyropoulou A., Zygoulis P., Kyparissi A., Gupta M., Gurjar M., Maji I. M., Hayes I., Kelly Y., Westbrook A., Fitzpatrick G., Maheshwari D., Motherway C., Negri G., Spadaro S., Nattino G., Pedeferri M., Boscolo A., Rossi S., 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. A., 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., Adorni A., Bocci M. G., Cortegiani A., Casalicchio T., Mellea S., Graziani E., Barattini M., Brizio E., Rossi M., Hahn M., Kemmerer N., Strietzel H. F., Dybwik K., Legernaes T., Klepstad P., Olaussen E. B., Olsen K. I., Brresen O. M., Bjorsvik G., Maini S., Fehrle L., Czuczwar M., Krawczyk P., Zietkiewicz M., Nowak L. R., Kotfis K., Cwyl K., Gajdosz R., Biernawska J., Bohatyrewicz R., Gawda R., Grudzien P., Nasilowski P., Popek N., Cyrankiewicz W., Wawrzyniak K., Wnuk M., Maciejewski D., Studzinska D., Zukowski M., Bernas S., Piechota M., Nowak I., Fronczek J., Serwa M., Machala W., Stefaniak J., Wujtewicz M., Maciejewski P., Szymkowiak M., Adamik B., Catorze N., Branco M. C., Barros I., Barros N., Krystopchuk A., Honrado T., Sousa C., Munoz F., Rebelo M., Gomes R., Nunes J., dias C., Fernandes A. M., Petrisor C., Constantin B., Belskiy V., Boskholov B., Rodriguez E., Rebollo S., Aguilar G., Masdeu G., Jaimes M. I., Mira A. P., Bodi M. A., Barea Mendoza J. A., Lopez-Cuenca S., Guzman M. H., Rico-Feijoo J., Ibarz M., Alvarez J. T., 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., Abraham P., Hergafi L., Schefold J. C., Biskup E., van Dijk I., van Lelyveld-Haas L. E. M., Ramnarain D., Jansen T., Nooteboom F., van der Voort P. H. J., de Lange D., Dieperink W., de Waard M. C., de Smet A. G., Bormans L., Dormans T., Dempsey G., Mathew S. J., Raj A. S., 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., 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., 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., and Nalapko Y.

Abstract

In the original publication Dr Patrick Meybohm of the Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Frankfurt University Hospital, Frankfurt, Germany was inadvertently omitted from the list of investigators.

Published
2018

11. Withholding or withdrawing of life-sustaining therapy in older adults (≥ 80 years) admitted to the intensive care unit

Author

Guidet, B, Flaatten, H, Boumendil, A, Morandi, A, Andersen, F, Artigas, A, Bertolini, G, 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, Zafeiridis, T, De Lange, D, Schmutz, R, Wimmer, F, Eller, P, Zotter, K, De Buysscher, P, De Neve, N, Swinnen, W, Abraham, P, Hergafi, L, 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, 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, Mira, A, Bodi, M, Barea Mendoza, J, Lopez-Cuenca, S, Guzman, M, Rico-Feijoo, J, Ibarz, M, 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, 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, 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, Ravani, I, Pagaki, E, Antoniou, A, Katsoulas, T, Kounougeri, A, Marinakis, G, Tsimpoukas, F, Spyropoulou, A, Zygoulis, P, Kyparissi, A, 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, 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, Adorni, A, Bocci, M, Cortegiani, A, Casalicchio, T, Mellea, S, Graziani, E, Barattini, M, Brizio, E, Rossi, M, van Dijk, I, van Lelyveld-Haas, L, Ramnarain, D, Jansen, T, Nooteboom, F, van der Voort, P, de Lange, D, Dieperink, W, de Waard, M, de Smet, A, Bormans, L, Dormans, T, Hahn, M, Kemmerer, N, Strietzel, H, Dybwik, K, Legernaes, T, Klepstad, P, Olaussen, E, Olsen, K, Brresen, O, Bjorsvik, G, Maini, S, Fehrle, L, Czuczwar, M, Krawczyk, P, Zietkiewicz, M, Nowak, L, Kotfis, K, Cwyl, K, Gajdosz, R, Biernawska, J, Bohatyrewicz, R, Gawda, R, Grudzien, P, Nasilowski, P, Popek, N, Cyrankiewicz, W, Wawrzyniak, K, Wnuk, M, Maciejewski, D, Studzinska, D, Zukowski, M, Bernas, S, Piechota, M, Nowak, I, Fronczek, J, Serwa, M, Machala, W, Stefaniak, J, Wujtewicz, M, Maciejewski, P, Szymkowiak, M, Adamik, B, Catorze, N, 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, Nalapko, Y, Guidet B., Flaatten H., Boumendil A., Morandi A., Andersen F. H., Artigas A., Bertolini G., Cecconi M., Christensen S., Faraldi L., Fjolner J., Jung C., Marsh B., Moreno R., Oeyen S., Ohman C. A., Pinto B. B., Soliman I. W., Szczeklik W., Valentin A., Watson X., Zafeiridis T., De Lange D. W., Schmutz R., Wimmer F., Eller P., Zotter K., De Buysscher P., De Neve N., Swinnen W., Abraham P., Hergafi L., Schefold J. C., Biskup E., Taliadoros I., Piza P., Lauten A., Sacher A. L., Brenner T., Franz M., Bloos F., Ebelt H., Schaller S. J., Fuest K., Rabe C., Dieck T., Steiner S., Graf T., Nia A. M., Janosi R. A., Simon P., Utzolino S., Rahmel T., Barth E., Schuster M., Dey N., Solling C., Rasmussen B. S., Rodriguez E., Rebollo S., Aguilar G., Masdeu G., Jaimes M. I., Mira A. P., Bodi M. A., Barea Mendoza J. A., Lopez-Cuenca S., Guzman M. H., Rico-Feijoo J., Ibarz M., Alvarez J. T., 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. J., Raj A. S., 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., 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., 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., Ravani I., Pagaki E., Antoniou A., Katsoulas T. A., Kounougeri A., Marinakis G., Tsimpoukas F., Spyropoulou A., Zygoulis P., Kyparissi A., Hayes I., Kelly Y., Westbrook A., Fitzpatrick G., Maheshwari D., Motherway C., Gupta M., Gurjar M., Maji I. M., Negri G., Spadaro S., Nattino G., Pedeferri M., Boscolo A., Rossi S., 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. A., 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., Adorni A., Bocci M. G., Cortegiani A., Casalicchio T., Mellea S., Graziani E., Barattini M., Brizio E., Rossi M., van Dijk I., van Lelyveld-Haas L. E. M., Ramnarain D., Jansen T., Nooteboom F., van der Voort P. H., de Lange D., Dieperink W., de Waard M. C., de Smet A. G. E., Bormans L., Dormans T., Hahn M., Kemmerer N., Strietzel H. F., Dybwik K., Legernaes T., Klepstad P., Olaussen E. B., Olsen K. I., Brresen O. M., Bjorsvik G., Maini S., Fehrle L., Czuczwar M., Krawczyk P., Zietkiewicz M., Nowak L. R., Kotfis K., Cwyl K., Gajdosz R., Biernawska J., Bohatyrewicz R., Gawda R., Grudzien P., Nasilowski P., Popek N., Cyrankiewicz W., Wawrzyniak K., Wnuk M., Maciejewski D., Studzinska D., Zukowski M., Bernas S., Piechota M., Nowak I., Fronczek J., Serwa M., Machala W., Stefaniak J., Wujtewicz M., Maciejewski P., Szymkowiak M., Adamik B., Catorze N., Branco M. C., Barros I., Barros N., Krystopchuk A., Honrado T., Sousa C., Munoz F., Rebelo M., Gomes R., Nunes J., Dias C., Fernandes A. M., 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., Nalapko Y., Guidet, B, Flaatten, H, Boumendil, A, Morandi, A, Andersen, F, Artigas, A, Bertolini, G, 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, Zafeiridis, T, De Lange, D, Schmutz, R, Wimmer, F, Eller, P, Zotter, K, De Buysscher, P, De Neve, N, Swinnen, W, Abraham, P, Hergafi, L, 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, 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, Mira, A, Bodi, M, Barea Mendoza, J, Lopez-Cuenca, S, Guzman, M, Rico-Feijoo, J, Ibarz, M, 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, 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, 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, Ravani, I, Pagaki, E, Antoniou, A, Katsoulas, T, Kounougeri, A, Marinakis, G, Tsimpoukas, F, Spyropoulou, A, Zygoulis, P, Kyparissi, A, 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, 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, Adorni, A, Bocci, M, Cortegiani, A, Casalicchio, T, Mellea, S, Graziani, E, Barattini, M, Brizio, E, Rossi, M, van Dijk, I, van Lelyveld-Haas, L, Ramnarain, D, Jansen, T, Nooteboom, F, van der Voort, P, de Lange, D, Dieperink, W, de Waard, M, de Smet, A, Bormans, L, Dormans, T, Hahn, M, Kemmerer, N, Strietzel, H, Dybwik, K, Legernaes, T, Klepstad, P, Olaussen, E, Olsen, K, Brresen, O, Bjorsvik, G, Maini, S, Fehrle, L, Czuczwar, M, Krawczyk, P, Zietkiewicz, M, Nowak, L, Kotfis, K, Cwyl, K, Gajdosz, R, Biernawska, J, Bohatyrewicz, R, Gawda, R, Grudzien, P, Nasilowski, P, Popek, N, Cyrankiewicz, W, Wawrzyniak, K, Wnuk, M, Maciejewski, D, Studzinska, D, Zukowski, M, Bernas, S, Piechota, M, Nowak, I, Fronczek, J, Serwa, M, Machala, W, Stefaniak, J, Wujtewicz, M, Maciejewski, P, Szymkowiak, M, Adamik, B, Catorze, N, 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, Nalapko, Y, Guidet B., Flaatten H., Boumendil A., Morandi A., Andersen F. H., Artigas A., Bertolini G., Cecconi M., Christensen S., Faraldi L., Fjolner J., Jung C., Marsh B., Moreno R., Oeyen S., Ohman C. A., Pinto B. B., Soliman I. W., Szczeklik W., Valentin A., Watson X., Zafeiridis T., De Lange D. W., Schmutz R., Wimmer F., Eller P., Zotter K., De Buysscher P., De Neve N., Swinnen W., Abraham P., Hergafi L., Schefold J. C., Biskup E., Taliadoros I., Piza P., Lauten A., Sacher A. L., Brenner T., Franz M., Bloos F., Ebelt H., Schaller S. J., Fuest K., Rabe C., Dieck T., Steiner S., Graf T., Nia A. M., Janosi R. A., Simon P., Utzolino S., Rahmel T., Barth E., Schuster M., Dey N., Solling C., Rasmussen B. S., Rodriguez E., Rebollo S., Aguilar G., Masdeu G., Jaimes M. I., Mira A. P., Bodi M. A., Barea Mendoza J. A., Lopez-Cuenca S., Guzman M. H., Rico-Feijoo J., Ibarz M., Alvarez J. T., 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. J., Raj A. S., 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., 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., 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., Ravani I., Pagaki E., Antoniou A., Katsoulas T. A., Kounougeri A., Marinakis G., Tsimpoukas F., Spyropoulou A., Zygoulis P., Kyparissi A., Hayes I., Kelly Y., Westbrook A., Fitzpatrick G., Maheshwari D., Motherway C., Gupta M., Gurjar M., Maji I. M., Negri G., Spadaro S., Nattino G., Pedeferri M., Boscolo A., Rossi S., 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. A., 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., Adorni A., Bocci M. G., Cortegiani A., Casalicchio T., Mellea S., Graziani E., Barattini M., Brizio E., Rossi M., van Dijk I., van Lelyveld-Haas L. E. M., Ramnarain D., Jansen T., Nooteboom F., van der Voort P. H., de Lange D., Dieperink W., de Waard M. C., de Smet A. G. E., Bormans L., Dormans T., Hahn M., Kemmerer N., Strietzel H. F., Dybwik K., Legernaes T., Klepstad P., Olaussen E. B., Olsen K. I., Brresen O. M., Bjorsvik G., Maini S., Fehrle L., Czuczwar M., Krawczyk P., Zietkiewicz M., Nowak L. R., Kotfis K., Cwyl K., Gajdosz R., Biernawska J., Bohatyrewicz R., Gawda R., Grudzien P., Nasilowski P., Popek N., Cyrankiewicz W., Wawrzyniak K., Wnuk M., Maciejewski D., Studzinska D., Zukowski M., Bernas S., Piechota M., Nowak I., Fronczek J., Serwa M., Machala W., Stefaniak J., Wujtewicz M., Maciejewski P., Szymkowiak M., Adamik B., Catorze N., Branco M. C., Barros I., Barros N., Krystopchuk A., Honrado T., Sousa C., Munoz F., Rebelo M., Gomes R., Nunes J., Dias C., Fernandes A. M., 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., and Nalapko Y.

Abstract

Purpose: To document and analyse the decision to withhold or withdraw life-sustaining treatment (LST) in a population of very old patients admitted to the ICU. Methods: This prospective study included intensive care patients aged ≥ 80 years in 309 ICUs from 21 European countries with 30-day mortality follow-up. Results: LST limitation was identified in 1356/5021 (27.2%) of patients: 15% had a withholding decision and 12.2% a withdrawal decision (including those with a previous withholding decision). Patients with LST limitation were older, more frail, more severely ill and less frequently electively admitted. Patients with withdrawal of LST were more frequently male and had a longer ICU length of stay. The ICU and 30-day mortality were, respectively, 29.1 and 53.1% in the withholding group and 82.2% and 93.1% in the withdrawal group. LST was less frequently limited in eastern and southern European countries than in northern Europe. The patient-independent factors associated with LST limitation were: acute ICU admission (OR 5.77, 95% CI 4.32–7.7), Clinical Frailty Scale (CFS) score (OR 2.08, 95% CI 1.78–2.42), increased age (each 5 years of increase in age had a OR of 1.22 (95% CI 1.12–1.34) and SOFA score [OR of 1.07 (95% CI 1.05–1.09 per point)]. The frequency of LST limitation was higher in countries with high GDP and was lower in religious countries. Conclusions: The most important patient variables associated with the instigation of LST limitation were acute admission, frailty, age, admission SOFA score and country. Trial registration: ClinicalTrials.gov (ID: NTC03134807)

Published
2018

12. Withholding or withdrawing of life-sustaining therapy in older adults (≥ 80 years) admitted to the intensive care unit

Author

Guidet B., Flaatten H., Boumendil A., Morandi A., Andersen F. H., Artigas A., Bertolini G., Cecconi M., Christensen S., Faraldi L., Fjolner J., Jung C., Marsh B., Moreno R., Oeyen S., Ohman C. A., Pinto B. B., Soliman I. W., Szczeklik W., Valentin A., Watson X., Zafeiridis T., De Lange D. W., Schmutz R., Wimmer F., Eller P., Zotter K., De Buysscher P., De Neve N., Swinnen W., Abraham P., Hergafi L., Schefold J. C., Biskup E., Taliadoros I., Piza P., Lauten A., Sacher A. L., Brenner T., Franz M., Bloos F., Ebelt H., Schaller S. J., Fuest K., Rabe C., Dieck T., Steiner S., Graf T., Nia A. M., Janosi R. A., Simon P., Utzolino S., Rahmel T., Barth E., Schuster M., Dey N., Solling C., Rasmussen B. S., Rodriguez E., Rebollo S., Aguilar G., Masdeu G., Jaimes M. I., Mira A. P., Bodi M. A., Barea Mendoza J. A., Lopez-Cuenca S., Guzman M. H., Rico-Feijoo J., Ibarz M., Alvarez J. T., 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. J., Raj A. S., 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., 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., 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., Ravani I., Pagaki E., Antoniou A., Katsoulas T. A., Kounougeri A., Marinakis G., Tsimpoukas F., Spyropoulou A., Zygoulis P., Kyparissi A., Hayes I., Kelly Y., Westbrook A., Fitzpatrick G., Maheshwari D., Motherway C., Gupta M., Gurjar M., Maji I. M., Negri G., Spadaro S., Nattino G., Pedeferri M., Boscolo A., Rossi S., 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. A., 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., Adorni A., Bocci M. G., Cortegiani A., Casalicchio T., Mellea S., Graziani E., Barattini M., Brizio E., Rossi M., van Dijk I., van Lelyveld-Haas L. E. M., Ramnarain D., Jansen T., Nooteboom F., van der Voort P. H., de Lange D., Dieperink W., de Waard M. C., de Smet A. G. E., Bormans L., Dormans T., Hahn M., Kemmerer N., Strietzel H. F., Dybwik K., Legernaes T., Klepstad P., Olaussen E. B., Olsen K. I., Brresen O. M., Bjorsvik G., Maini S., Fehrle L., Czuczwar M., Krawczyk P., Zietkiewicz M., Nowak L. R., Kotfis K., Cwyl K., Gajdosz R., Biernawska J., Bohatyrewicz R., Gawda R., Grudzien P., Nasilowski P., Popek N., Cyrankiewicz W., Wawrzyniak K., Wnuk M., Maciejewski D., Studzinska D., Zukowski M., Bernas S., Piechota M., Nowak I., Fronczek J., Serwa M., Machala W., Stefaniak J., Wujtewicz M., Maciejewski P., Szymkowiak M., Adamik B., Catorze N., Branco M. C., Barros I., Barros N., Krystopchuk A., Honrado T., Sousa C., Munoz F., Rebelo M., Gomes R., Nunes J., Dias C., Fernandes A. M., 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., Nalapko Y., 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), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), University of Bergen (UiB), Haukeland University Hospital, Norwegian University of Science and Technology [Trondheim] (NTNU), Norwegian University of Science and Technology (NTNU), Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Universitat Autònoma de Barcelona (UAB), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), St George's, University of London, Aarhus University Hospital, Ghent University Hospital, Karolinska University Hospital [Stockholm], Hôpitaux Universitaires de Genève (HUG), University Medical Center [Utrecht], Utrecht University [Utrecht], Uniwersytet Jagielloński w Krakowie = Jagiellonian University (UJ), Guidet, B, Flaatten, H, Boumendil, A, Morandi, A, Andersen, F, Artigas, A, Bertolini, G, 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, Zafeiridis, T, De Lange, D, Schmutz, R, Wimmer, F, Eller, P, Zotter, K, De Buysscher, P, De Neve, N, Swinnen, W, Abraham, P, Hergafi, L, 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, 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, Mira, A, Bodi, M, Barea Mendoza, J, Lopez-Cuenca, S, Guzman, M, Rico-Feijoo, J, Ibarz, M, 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, 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, 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, Ravani, I, Pagaki, E, Antoniou, A, Katsoulas, T, Kounougeri, A, Marinakis, G, Tsimpoukas, F, Spyropoulou, A, Zygoulis, P, Kyparissi, A, 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, 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, Adorni, A, Bocci, M, Cortegiani, A, Casalicchio, T, Mellea, S, Graziani, E, Barattini, M, Brizio, E, Rossi, M, van Dijk, I, van Lelyveld-Haas, L, Ramnarain, D, Jansen, T, Nooteboom, F, van der Voort, P, de Lange, D, Dieperink, W, de Waard, M, de Smet, A, Bormans, L, Dormans, T, Hahn, M, Kemmerer, N, Strietzel, H, Dybwik, K, Legernaes, T, Klepstad, P, Olaussen, E, Olsen, K, Brresen, O, Bjorsvik, G, Maini, S, Fehrle, L, Czuczwar, M, Krawczyk, P, Zietkiewicz, M, Nowak, L, Kotfis, K, Cwyl, K, Gajdosz, R, Biernawska, J, Bohatyrewicz, R, Gawda, R, Grudzien, P, Nasilowski, P, Popek, N, Cyrankiewicz, W, Wawrzyniak, K, Wnuk, M, Maciejewski, D, Studzinska, D, Zukowski, M, Bernas, S, Piechota, M, Nowak, I, Fronczek, J, Serwa, M, Machala, W, Stefaniak, J, Wujtewicz, M, Maciejewski, P, Szymkowiak, M, Adamik, B, Catorze, N, 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, Nalapko, Y, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Guidet, Bertrand, Flaatten, Han, Boumendil, Ariane, Morandi, Alessandro, Andersen, Finn H., Artigas, Antonio, Bertolini, Guido, 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, Zafeiridis, Tilemacho, de Lange, Dylan W., Schmutz, René, Wimmer, Franz, Eller, Philipp, Zotter, Klemen, de Buysscher, Pieter, de Neve, Nikolaa, Swinnen, Walter, Abraham, Paul, Hergafi, Leila, 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, 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, Mira, Ángela Prado, Bodi, Maria A., Barea Mendoza, Jesus A., López-Cuenca, Sonia, Guzman, Marcela Homez, Rico-Feijoo, Jesú, Ibarz, Mercede, Alvarez, Josep Trenado, 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, 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, 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, Ravani, Ifigenia, Pagaki, Eumorfia, Antoniou, Angela, Katsoulas, Theodoros A., Kounougeri, Aikaterini, Marinakis, George, Tsimpoukas, Fotio, Spyropoulou, Anastasia, Zygoulis, Pari, Kyparissi, Aikaterini, 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, 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, van Dijk, I., van Lelyveld-Haas, L.E.M., Ramnarain, D., Jansen, Tim, Nooteboom, Fleur, van der Voort, Peter HJ, de Lange, Dylan, Dieperink, Willem, de Waard, Monique C., de Smet, Annemarie G. E., Bormans, Laura, Dormans, Tom, Hahn, Michael, Kemmerer, Nicolai, Strietzel, Hans Frank, Dybwik, Knut, Legernaes, Terje, Klepstad, Pål, Olaussen, Even Braut, Olsen, Knut Inge, Brresen, Ole Mariu, Bjorsvik, Geir, Maini, Sameer, Fehrle, Lutz, Czuczwar, Miroslaw, Krawczyk, Pawel, Ziętkiewicz, Mirosław, Nowak, Łukasz R., Kotfis, Katarzyna, Cwyl, Katarzyna, Gajdosz, Ryszard, Biernawska, Jowita, Bohatyrewicz, Romuald, Gawda, Ryszard, Grudzień, Paweł, Nasiłowski, Paweł, Popek, Natalia, Cyrankiewicz, Waldemar, Wawrzyniak, Katarzyna, Wnuk, Marek, Maciejewski, Dariusz, Studzińska, Dorota, Żukowski, Maciej, Bernas, Szymon, Piechota, Mariusz, Nowak, Ilona, Fronczek, Jakub, Serwa, Marta, Machała, Waldemar, Stefaniak, Jan, Wujtewicz, Maria, Maciejewski, Paweł, Szymkowiak, Małgorzata, Adamik, Barbara, Catorze, Nuno, Branco, Miguel Castelo, 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, Nalapko, Yuiry, and Critical Care

Subjects
Male, medicine.medical_treatment, HSJ UCI, Critical Care and Intensive Care Medicine, law.invention, Life sustaining treatment, 0302 clinical medicine, Elderly, law, 80 and over, Medicine, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Aged, 80 and over, education.field_of_study, Withholding Treatment, ddc:617, [SDV.MHEP.GEG]Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, Withholding, Intensive care unit, 3. Good health, Europe, aged, Intensive Care Units, Withdrawal, SOFA score, Human, medicine.medical_specialty, ethical aspects, Population, Intensive Care Unit, Decision Making, Ethics, Intensive care, life-sustaining therapy, NO, 03 medical and health sciences, Anesthesiology, Humans, Ethic, education, Mechanical ventilation, business.industry, 030208 emergency & critical care medicine, critical care, Life Support Care, Prospective Studie, Emergency medicine, business
Abstract

PURPOSE: To document and analyse the decision to withhold or withdraw life-sustaining treatment (LST) in a population of very old patients admitted to the ICU. METHODS: This prospective study included intensive care patients aged ≥ 80 years in 309 ICUs from 21 European countries with 30-day mortality follow-up. RESULTS: LST limitation was identified in 1356/5021 (27.2%) of patients: 15% had a withholding decision and 12.2% a withdrawal decision (including those with a previous withholding decision). Patients with LST limitation were older, more frail, more severely ill and less frequently electively admitted. Patients with withdrawal of LST were more frequently male and had a longer ICU length of stay. The ICU and 30-day mortality were, respectively, 29.1 and 53.1% in the withholding group and 82.2% and 93.1% in the withdrawal group. LST was less frequently limited in eastern and southern European countries than in northern Europe. The patient-independent factors associated with LST limitation were: acute ICU admission (OR 5.77, 95% CI 4.32-7.7), Clinical Frailty Scale (CFS) score (OR 2.08, 95% CI 1.78-2.42), increased age (each 5 years of increase in age had a OR of 1.22 (95% CI 1.12-1.34) and SOFA score [OR of 1.07 (95% CI 1.05-1.09 per point)]. The frequency of LST limitation was higher in countries with high GDP and was lower in religious countries. CONCLUSIONS: The most important patient variables associated with the instigation of LST limitation were acute admission, frailty, age, admission SOFA score and country. TRIAL REGISTRATION: ClinicalTrials.gov (ID: NTC03134807). info:eu-repo/semantics/publishedVersion

Published
2018

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

Author

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 H., De Lange D. W., Morandi A., Andersen F. H., Artigas A., Bertolini G., Boumendil A., Cecconi M., Christensen S., Faraldi L., Fjolner J., Jung C., Marsh B., Moreno R., Oeyen S., Ohman C. A., Pinto B. B., Soliman I. W., 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. C., Biskup E., Taliadoros I., Piza P., Lauten A., Sacher A. L., Brenner T., Franz M., Bloos F., Ebelt H., Schaller S. J., Fuest K., Rabe C., Dieck T., Steiner S., Graf T., Nia A. M., Janosi R. A., Meybohm P., Simon P., Utzolino S., Rahmel T., Barth E., Schuster M., Dey N., Solling C., Rasmussen B. S., Rodriguez E., Rebollo S., Aguilar G., Masdeu G., Jaimes M. I., Prado Mira A., Bodi M. A., Barea Mendoza J. A., 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. J., Raj A. S., 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. A., 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. M., 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. A., 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. G., Cortegiani A., Casalicchio T., Mellea S., Graziani E., Barattini M., van Dijk I., van Lelyveld-Haas L. E. M., Ramnarain D., Jansen T., Nooteboom F., van der Voort P. H. J., Dieperink W., de Waard M. C., Bormans L., Hahn M., Kemmerer N., Strietzel HF., Fehrle L., Dybwik K., Legernaes T., Klepstad P., Olaussen E. B., Olsen K. I., Borresen O. M., Bjorsvik G., Maini S., Czuczwar M., Krawczyk P., Zietkiewicz M., Nowak L. R., 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. M., 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, 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 H., De Lange D. W., Morandi A., Andersen F. H., Artigas A., Bertolini G., Boumendil A., Cecconi M., Christensen S., Faraldi L., Fjolner J., Jung C., Marsh B., Moreno R., Oeyen S., Ohman C. A., Pinto B. B., Soliman I. W., 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. C., Biskup E., Taliadoros I., Piza P., Lauten A., Sacher A. L., Brenner T., Franz M., Bloos F., Ebelt H., Schaller S. J., Fuest K., Rabe C., Dieck T., Steiner S., Graf T., Nia A. M., Janosi R. A., Meybohm P., Simon P., Utzolino S., Rahmel T., Barth E., Schuster M., Dey N., Solling C., Rasmussen B. S., Rodriguez E., Rebollo S., Aguilar G., Masdeu G., Jaimes M. I., Prado Mira A., Bodi M. A., Barea Mendoza J. A., 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. J., Raj A. S., 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. A., 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. M., 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. A., 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. G., Cortegiani A., Casalicchio T., Mellea S., Graziani E., Barattini M., van Dijk I., van Lelyveld-Haas L. E. M., Ramnarain D., Jansen T., Nooteboom F., van der Voort P. H. J., Dieperink W., de Waard M. C., Bormans L., Hahn M., Kemmerer N., Strietzel HF., Fehrle L., Dybwik K., Legernaes T., Klepstad P., Olaussen E. B., Olsen K. I., Borresen O. M., Bjorsvik G., Maini S., Czuczwar M., Krawczyk P., Zietkiewicz M., Nowak L. R., 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. M., 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., and Yapici N.

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 30 days 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 (≥ 80 years) 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 30 days. Results: A total of 5021 patients with a median age of 84 years (IQR 81–86 years) 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 (≥ 80 years) 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. T

Published
2017

20. 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

21. Intensive care unit burden is associated with increased mortality in critically ill COVID-19 patients.

Author

Didriksson I, Leffler M, Spångfors M, Lindberg S, Reepalu A, Nilsson A, Cronqvist J, Andertun S, Nelderup M, Jungner M, Johnsson P, Lilja G, Frigyesi A, and Friberg H

Subjects
Humans, Male, Aged, Middle Aged, Female, SARS-CoV-2, Cohort Studies, Prospective Studies, Critical Illness, Intensive Care Units, COVID-19 therapy
Abstract

Background: Traditional models to predict intensive care outcomes do not perform well in COVID-19. We undertook a comprehensive study of factors affecting mortality and functional outcome after severe COVID-19., Methods: In this prospective multicentre cohort study, we enrolled laboratory-confirmed, critically ill COVID-19 patients at six ICUs in the Skåne Region, Sweden, between May 11, 2020, and May 10, 2021. Demographics and clinical data were collected. ICU burden was defined as the total number of ICU-treated COVID-19 patients in the region on admission. Surviving patients had a follow-up at 90 days for assessment of functional outcome using the Glasgow Outcome Scale-Extended (GOSE), an ordinal scale (1-8) with GOSE ≥5 representing a favourable outcome. The primary outcome was 90-day mortality; the secondary outcome was functional outcome at 90 days., Results: Among 498 included patients, 74% were male with a median age of 66 years and a median body mass index (BMI) of 30 kg/m 2 . Invasive mechanical ventilation was employed in 72%. Mortality in the ICU, in-hospital and at 90 days was 30%, 38% and 39%, respectively. Mortality increased markedly at age 60 and older. Increasing ICU burden was independently associated with a two-fold increase in mortality. Higher BMI was not associated with increased mortality. Besides age and ICU burden, smoking status, cortisone use, P a CO 2 >7 kPa, and inflammatory markers on admission were independent factors of 90-day mortality. Lower GOSE at 90 days was associated with a longer stay in the ICU., Conclusion: In critically ill COVID-19 patients, the 90-day mortality was 39% and increased considerably at age 60 or older. The ICU burden was associated with mortality, whereas a high BMI was not. A longer stay in the ICU was associated with unfavourable functional outcomes at 90 days., (© 2022 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.)

Published
2023
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22. Protocolised reduction of non-resuscitation fluids versus usual care in patients with septic shock (REDUSE): a protocol for a multicentre feasibility trial.

Author

Lindén A, Fisher J, Lilja G, Olsen MH, Sjövall F, Jungner M, Spångfors M, Samuelsson L, Oras J, Linder A, Unden J, Kander T, Lipcsey M, Nielsen N, Jakobsen JC, and Bentzer P

Subjects
Adult, Humans, Feasibility Studies, Quality of Life, Critical Care, Randomized Controlled Trials as Topic, Multicenter Studies as Topic, Shock, Septic therapy, Acute Kidney Injury
Abstract

Introduction: Administration of large volumes of fluids is associated with poor outcome in septic shock. Recent data suggest that non-resuscitation fluids are the major source of fluids in the intensive care unit (ICU) patients suffering from septic shock. The present trial is designed to test the hypothesis that a protocol targeting this source of fluids can reduce fluid administration compared with usual care., Methods and Analysis: The design will be a multicentre, randomised, feasibility trial. Adult patients admitted to ICUs with septic shock will be randomised within 12 hours of admission to receive non-resuscitation fluids either according to a restrictive protocol or to receive usual care. The healthcare providers involved in the care of participants will not be blinded. The participants, outcome assessors at the 6-month follow-up and statisticians will be blinded. Primary outcome will be litres of fluids administered within 3 days of randomisation. Secondary outcomes will be proportion of randomised participants with outcome data on all-cause mortality; days alive and free of mechanical ventilation within 90 days of inclusion; any acute kidney injury and ischaemic events in the ICU (cerebral, cardiac, intestinal or limb ischaemia); proportion of surviving randomised patients who were assessed by European Quality of Life 5-Dimensions 5-Level questionnaire and Montreal Cognitive Assessment; proportion of all eligible patients who were randomised and proportion of participants experiencing at least one protocol violation., Ethics and Dissemination: Ethics approval has been obtained in Sweden. Results of the primary and secondary outcomes will be submitted for publication in a peer-reviewed journal., Trial Registration Number: NCT05249088., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2023
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23. Survey of non-resuscitation fluids administered during septic shock: a multicenter prospective observational study.

Author

Lindén-Søndersø A, Jungner M, Spångfors M, Jan M, Oscarson A, Choi S, Kander T, Undén J, Griesdale D, Boyd J, and Bentzer P

Abstract

Background: The indication, composition and timing of administration of non-resuscitation fluid in septic shock have so far received little attention and accordingly the potential to reduce this source of fluid is unknown. The objective of the study was to quantify and characterize non-resuscitation fluid administered to patients with septic shock., Methods: This prospective observational study was performed in eight intensive care units in Sweden and Canada during 4 months in 2018. Adult patients with septic shock within 24 h of admission to the intensive care unit were eligible for inclusion. Non-resuscitation fluids were defined as fluids other than colloids, blood products and crystalloids at a rate ≥ 5 ml/kg/h. Indication, volume and type of fluid were recorded during the first 5 days after admission. A maximum of 30 patients could be included per centre. To estimate the potential to reduce administration of non-resuscitation fluid, a pragmatic "restrictive" protocol for administration of non-resuscitation fluids was devised based on the most restrictive practice already in place for non-resuscitation fluids at any of the participating centres. Data are presented as median (interquartile range [IQR])., Results: A total of 200 patients were included in the study and the 30-day mortality was 35%. Patients received a total of 7870 (4060-12,340) ml of non-resuscitation fluids and 2820 (1430-4580) of resuscitation fluids during the observation period. Median volumes of non-resuscitation and resuscitation fluids were similar at day 1 (1620 [710-2320] and 1590 [520-3000]) ml, respectively) and non-resuscitation fluids represented the largest source of fluid from day 2 and onwards after admission to the ICU. Vehicles for drugs such as vasoactive drugs and antibiotics constituted the largest fraction of non-resuscitation fluids (2400 [1270-4030] ml) during the 5-day observation period. Modelling suggested that volume of non-resuscitation fluids could be reduced by 2840 (1270-4900) ml during the first 5 days of admission to the ICU, mainly through reducing maintenance fluids., Conclusions: Non-resuscitation fluids constitute the major fraction of fluids administered in the ICU to patients suffering from septic shock and may represent the largest modifiable target to reduce fluid overload.

Published
2019
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24. Sinus floor elevation procedures to enable implant placement and integration: techniques, biological aspects and clinical outcomes.

Author

Lundgren S, Cricchio G, Hallman M, Jungner M, Rasmusson L, and Sennerby L

Subjects
Bone Transplantation methods, Dental Prosthesis Design, Humans, Jaw, Edentulous, Partially surgery, Osteotomy methods, Surface Properties, Dental Implantation, Endosseous methods, Dental Implants, Sinus Floor Augmentation methods
Abstract

Implant treatment in an atrophied edentulous posterior maxilla constitutes a challenge for the therapeutic team. The authors of the present study acknowledge that modern micro-rough surface implants in lengths of about 8-10 mm or longer and of different brands are similarly successful. Consequently, the authors propose that the use of different sinus floor elevation techniques should be considered when < 8 mm of bone is available below the maxillary sinus. The type of sinus floor elevation technique selected is mainly based on residual vertical bone height, marginal bone width, local intrasinus anatomy and the number of teeth to be replaced, although other factors (such as surgical training and surgical experience) may have an impact. It is proposed that a transcrestal sinus floor elevation approach can be considered as a first-choice method for single tooth gaps in situations with sufficient width for implant placement and a residual bone height of 5-8 mm, while lateral sinus floor elevation, with or without grafting materials, is indicated when < 5 mm of bone is available and when several teeth are to be replaced. With regard to time of implant placement, a one-stage procedure is preferred provided that high primary stability can be ensured., (© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Published
2017
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25. Blood-brain barrier permeability following traumatic brain injury.

Author

Jungner M, Siemund R, Venturoli D, Reinstrup P, SCHALéN W, and Bentzer P

Subjects
Adult, Aged, Animals, Brain physiopathology, Brain Edema physiopathology, Capillary Permeability physiology, Case-Control Studies, Contrast Media pharmacokinetics, Female, Humans, Iohexol pharmacokinetics, Male, Middle Aged, Time Factors, Tomography, X-Ray Computed, Young Adult, Blood-Brain Barrier physiopathology, Brain Injuries, Traumatic physiopathology
Abstract

Background: Brain edema and intracranial hypertension is deleterious after traumatic brain injury (TBI), but the underlying pathophysiology is complex and poorly understood. One major subject of controversy is the time course and extent of blood-brain barrier (BBB) dysfunction following trauma, and previous studies in humans have only provided semi-quantitative data. The objective of the present study was therefore to quantify changes in BBB-permeability in the early course of TBI, when brain edema is still evolving., Methods: Sixteen non-consecutive brain trauma patients and two controls were included. Following i.v. injection of iohexol and CT perfusion scans, patients were scanned eight times from 4 to 25 minutes. Blood to brain transfer constant (Ki) for iohexol (molecular weight 821 D), reflecting permeability and available area for diffusion, was calculated offline by Patlak plot analysis of the enhancement curves of intracerebral large venous vessels and pericontusional brain parenchyma., Results: In non-ischemic tissue surrounding contusions and hematomas Ki was increased 2- to 10-fold compared to normal tissue, reaching maximal values of 0.5 mL/min/100 g. In non-injured areas and in controls Ki was about 0.06 mL/min/100 g. The increase was more pronounced in the most severely injured patients, and was detectable within 24 hours after trauma and up to five days after., Conclusions: Our results suggest that traumatic brain injury is associated with early focal increases in small molecular BBB-permeability. The results indicate that in the injured brain, capillary hydrostatic and oncotic pressures may influence edema formation.

Published
2016

26. On the Early Mechanisms of Bone Formation after Maxillary Sinus Membrane Elevation: An Experimental Histological and Immunohistochemical Study.

Author

Jungner M, Cricchio G, Salata LA, Sennerby L, Lundqvist C, Hultcrantz M, and Lundgren S

Subjects
Animals, Bone Transplantation, Cebus, Immunohistochemistry, Male, Models, Animal, Tibia transplantation, Dental Implants, Osteogenesis physiology, Sinus Floor Augmentation methods
Abstract

Background: Previous studies have shown predictable bone formation in the maxillary sinus after membrane elevation. However, how and where the bone is formed is not well understood., Purpose: The aim of the study was to histologically and immunohistochemically study the early bone formation events in primates after membrane elevation in the maxillary sinus., Materials and Methods: Nine adult male tufted capuchin primates (Cebus apella) were included in the study. Eight animals were subjected to bilateral maxillary sinus membrane elevation using a lateral replaceable bone window technique. One oxidized dental implant was placed into the maxillary sinus cavity on both sides. In four animals, one sinus was left without any additional treatment, whereas the contralateral sinus was filled with autologous bone grafts from the tibia. In two animals, the implants were inserted under the elevated sinus membrane on both sides. In two animals, the sinus membrane was totally removed. The animals were euthanized after 10 or 45 days. One nonoperated animal representing pristine tissue conditions served as control. The maxillary sinuses with implants were retrieved and further processed for light microscopic ground sections or decalcified sections for immune-histochemical analyses., Results: Bone formation started from the bottom of the sinus floor, sprouting into the granulation tissue along the implant surface under the elevated membrane irrespective of time and surgical technique. Bone formation was not seen in direct conjunction with the sinus membrane. A distinct expression of osteopontin was observed in the serous glands of the lamina propria close to the implant within all groups., Conclusion: Bone formation after sinus membrane elevation with or without additional bone grafts starts at the sinus floor and sprouts into the elevated space along the implant surface. The sinus membrane does not seem to present osteoinductive potential in sinus membrane elevation procedures in this study., (© 2014 Wiley Periodicals, Inc.)

Published
2015
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27. Follow-up study of implants with turned or oxidized surfaces placed after sinus augmentation.

Author

Jungner M, Legrell PE, and Lundgren S

Subjects
Aged, Aged, 80 and over, Alveolar Bone Loss diagnostic imaging, Autografts transplantation, Bone Transplantation methods, Cone-Beam Computed Tomography methods, Dental Restoration Failure, Female, Follow-Up Studies, Gingival Hemorrhage classification, Humans, Longitudinal Studies, Male, Maxilla diagnostic imaging, Maxillary Sinus diagnostic imaging, Middle Aged, Nasal Mucosa diagnostic imaging, Paranasal Sinus Diseases diagnostic imaging, Periodontal Pocket classification, Surface Properties, Survival Analysis, Treatment Outcome, Dental Implantation, Endosseous methods, Dental Implants, Dental Prosthesis Design, Sinus Floor Augmentation methods
Abstract

Purpose: To compare long-term survival and clinical outcomes of endosseous implants with different surface characteristics in patients with sinus elevation procedures, autologous bone grafting, and delayed implant placement., Materials and Methods: Implant survival, peri-implant soft tissue conditions, marginal bone level, intrasinus apical bone level, and sinus health were studied in patients subjected to autologous bone graft and delayed placement of implants with turned or oxidized surfaces. After a minimum of 5 years of functional loading, all patients were clinically examined regarding gingival pocket depth (PD) and bleeding on probing (BoP). The marginal bone level (MBL) was measured in intraoral radiographs. Cone beam computed tomography was used to evaluate the apical bone level (ABL) of the implants and intrasinus conditions., Results: Twenty-eight patients received sinus elevation and a total of 92 dental implants. Thirteen patients received 47 implants with a turned surface, and 15 patients received 45 implants with an oxidized surface. Mean follow-up was 10 years (range, 5 to 19 years). No significant difference was found between the two implant surfaces in terms of PD, BoP, MBL, or ABL. Four patients (14%) exhibited radiographic signs of sinus pathology, with opacification, polyp-like structures, and thickening of the sinus membrane. Radiographic signs of sinus pathology were not correlated to implant survival or to the investigated parameters., Conclusion: Grafting of the maxillary sinus floor with intraorally harvested bone and delayed placement of either turned or oxidized implants results in equally high long-term survival rates, stable marginal and apical bone levels, and good peri-implant soft tissue health.

Published
2014
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28. A retrospective comparison of oxidized and turned implants with respect to implant survival, marginal bone level and peri-implant soft tissue conditions after at least 5 years in function.

Author

Jungner M, Lundqvist P, and Lundgren S

Subjects
Adult, Aged, Aged, 80 and over, Bone and Bones pathology, Female, Humans, Male, Middle Aged, Oxidation-Reduction, Retrospective Studies, Dental Implants
Abstract

Background: Long-term clinical follow-up studies comparing different implant surfaces with regard to survival and marginal conditions are rare., Objectives: The objective of this study was to compare the clinical performance of turned and oxidized implants after more than 5 years of loading., Material and Methods: One hundred three patients (43 men, 60 women; mean age 67.4 years, range 32-90) previously treated with 287 implants (Nobel Biocare AB, Gothenburg, Sweden), 133 with turned surface (MKIII, Nobel Biocare AB) and 154 with an oxidized surface (MKIII, TiUnite, Nobel Biocare AB) were examined after at least 5 years of loading (mean 82 months, range 60-93 months). The implants had been used for support of single crowns (33 patients/36 implants), partial bridges (39 patients/103 implants), or full bridges (31 patients/148 implants) following an early loading protocol (14 patients /54 implants), a one-stage protocol (32 patients/59 implants) or a two-stage protocol (57 patients/174 implants). Clinical examinations of bleeding on probing (BoP) and pocket depth (PD) were performed. Intraoral radiographs were used for assessments of marginal bone levels (MBLs)., Results: Seven turned implants and one oxidized implant failed, giving overall cumulative survival rates of 94.7 and 99.4%, respectively. There were no differences for BoP scores (0.5 ± 0.7 vs 0.4 ± 0.6) and PD measurements (1.7 ± 0.8 mm vs 1.8 ± 1.0 mm) parameters when comparing turned and oxidized implants, respectively. The mean MBL was 1.8 ± 0.8 mm and 2.0 ± 0.9 mm for turned and oxidized implants, respectively, after more than 5 years in function (NS). Frequency distribution of MBL loss showed no statistically significant differences between the two surfaces. A total of four implants (1.4%) (three oxidized and one turned) showed a PD > 3 mm, MBL > 4 mm, and BoP. However, none of these were associated with suppuration on examination., Conclusion: The present study does not state any differences in implant failure, MBL, presence of bleeding or PD around implants when comparing turned and oxidized titanium implants after at least 5 years of function., (© 2012 Wiley Periodicals, Inc.)

Published
2014
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29. Intracranial pressure following resuscitation with albumin or saline in a cat model of meningitis.

Author

Jungner M, Bentzer P, and Grände PO

Subjects
Animals, Blood Pressure Determination, Cats, Cerebrovascular Circulation drug effects, Disease Models, Animal, Infusions, Intravenous, Lipopolysaccharides pharmacology, Male, Random Allocation, Reference Values, Survival Rate, Treatment Outcome, Albumins pharmacology, Intracranial Pressure drug effects, Meningitis, Bacterial mortality, Meningitis, Bacterial therapy, Resuscitation methods, Sodium Chloride pharmacology
Abstract

Objective: To compare the intracranial pressure after resuscitation to normovolemia by using 20% albumin or normal saline in a cat model of meningitis., Design: Prospective, randomized animal study., Setting: University hospital laboratory., Subjects: Twenty adult, male cats., Interventions: Meningitis was induced by intrathecal injection of Escherichia coli-derived lipopolysaccharide (0.8 × 10 units/kg). Four hours after the lipopolysaccharide injection, the animals were randomized to intravenous treatment with 0.4 mL/kg/hr of 20% albumin or 7.5 mL/kg/hr of 0.9% sodium chloride for 6 hrs (n = 7 per group). A control group receiving lipopolysaccharide but no fluid was also studied (n = 6)., Measurements and Main Results: Effects on intracranial pressure, mean arterial pressure, plasma volume (I-albumin technique), plasma oncotic pressure, and brain metabolism via cerebral interstitial lactate/pyruvate ratio and glycerol and glucose levels (microdialysis technique) were evaluated. Plasma volume decreased by approximately 20% and intracranial pressure increased from 10 to approximately 20 mm Hg at 4 hrs after the lipopolysaccharide injection. Six hours later, plasma volume had returned to baseline in both fluid groups while there was a further reduction in the control group. Intracranial pressure was higher in the saline group than in the albumin and control groups and was 25.8 ± 2.8 mm Hg, 18.3 ± 0.6 mm Hg, and 20.4 ± 1.7 mm Hg, respectively. Plasma oncotic pressure was higher in the albumin group than in the saline and control groups. Mean arterial pressure and microdialysis data were within normal range and did not differ among the groups., Conclusions: The results showed that the choice of resuscitation fluid may influence intracranial pressure in meningitis. The lower intracranial pressure in the colloid group may be explained by a higher plasma oncotic pressure and less fluid distribution to the brain interstitium.

Published
2011
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30. Effects on brain edema of crystalloid and albumin fluid resuscitation after brain trauma and hemorrhage in the rat.

Author

Jungner M, Grände PO, Mattiasson G, and Bentzer P

Subjects
Albumins administration & dosage, Animals, Blood Volume physiology, Brain Edema chemically induced, Brain Edema physiopathology, Brain Injuries complications, Brain Injuries physiopathology, Cerebral Hemorrhage complications, Cerebral Hemorrhage physiopathology, Crystalloid Solutions, Isotonic Solutions administration & dosage, Male, Rats, Rats, Sprague-Dawley, Albumins adverse effects, Brain Edema drug therapy, Brain Injuries drug therapy, Cerebral Hemorrhage drug therapy, Isotonic Solutions adverse effects, Resuscitation adverse effects
Abstract

Background: It has been hypothesized that resuscitation with crystalloids after brain trauma increases brain edema compared with colloids, but previous studies on the subject have been inconclusive. To test this hypothesis, the authors compared groups resuscitated with either colloid or crystalloid., Methods: After fluid percussion injury, rats were subjected to a controlled hemorrhage of 20 ml/kg and were randomized to 5% albumin at 20 ml/kg (A20), isotonic Ringer's acetate at 50 ml/kg (C50), or 90 ml/kg (C90). After 3 or 24 h, water content in the injured cortex was determined using a wet/dry weight method. Blood volume was calculated from plasma volume, measured by 125I-albumin dilution, and hematocrit. Oncotic pressure and osmolality were measured with osmometers., Results: At 3 h, blood volume was equal in the A20 and C90 groups and lower in the C50 group. Oncotic pressure was reduced by 35-40% in the crystalloid groups and unchanged in the albumin group. Cortical water content in the A20 group was lower than in the C90 group (81.3 +/- 0.5% vs. 82.1 +/- 1.1%, P < 0.05), but it was not different from the C50 group (81.8 +/- 1.1%). At 24 h, oncotic pressure and blood volume were normalized in all groups, and cortical water content was significantly lower in the albumin group than in the crystalloid groups. Osmolality and arterial pressure were equal in all groups throughout the experiment., Conclusions: When given to the same intravascular volume expansion, isotonic crystalloids caused greater posttraumatic brain edema than 5% albumin at 3 and 24 h after trauma.

Published
2010
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31. Oxidized titanium implants (Nobel Biocare TiUnite) compared with turned titanium implants (Nobel Biocare mark III) with respect to implant failure in a group of consecutive patients treated with early functional loading and two-stage protocol.

Author

Jungner M, Lundqvist P, and Lundgren S

Subjects
Adult, Aged, Aged, 80 and over, Biocompatible Materials, Female, Humans, Male, Middle Aged, Surface Properties, Time Factors, Weight-Bearing, Dental Implants, Dental Restoration Failure, Titanium
Abstract

Objectives: The purpose of this study was to compare two implant types of similar shape but with different surfaces with respect to implant failure., Material and Methods: A total of 136 patients were treated with Nobel Biocare Implants between January 2001 and December 2002. Totally 394 implants were placed, of which 199 were oxidized titanium implants (Nobel Biocare TiUnite and 195 with turned titanium surface (Nobel Biocare Mark III. Sixty-three patients underwent a one-stage surgical protocol, of which 24 were objected to early functional loading. The remaining 73 patients were treated with a traditional two-stage surgical protocol. All patients were followed for a minimum of 5 months after loading of the implants. Implants were classified as survivals when clinically stable and fulfilling purported function without any discomfort to the patient, with no signs of infection or ongoing pathologic process., Results: Seven implants were lost in five patients (two males and three females), six in the maxilla and one in the mandible. All failed implants were Mark III implants, inserted following the traditional two-stage protocol. The implant success rate was 98.2% for the whole-patient group, divided as a 100% success rate following the implants with oxidized surface (Nobel Biocare TiUnite compared with a success rate of 96.4% with implants with turned surface (Nobel Biocare Mark III).

Published
2005
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32. [Anesthesia in hereditary peripheral muscular disease].

Author

Islander G and Jungner M

Subjects
Contraindications, Humans, Malignant Hyperthermia complications, Malignant Hyperthermia genetics, Malignant Hyperthermia surgery, Malignant Hyperthermia therapy, Monitoring, Intraoperative, Postoperative Complications chemically induced, Postoperative Complications etiology, Postoperative Complications prevention & control, Practice Guidelines as Topic, Risk Factors, Succinylcholine adverse effects, Anesthesia, General adverse effects, Anesthesia, General methods, Anesthetics, Inhalation adverse effects, Muscular Dystrophies complications, Muscular Dystrophies genetics, Muscular Dystrophies surgery, Neuromuscular Depolarizing Agents adverse effects, Paralyses, Familial Periodic complications, Paralyses, Familial Periodic genetics, Paralyses, Familial Periodic surgery
Published
2005

33. Interfacial regulation of bacterial sphingomyelinase activity.

Author

Jungner M, Ohvo H, and Slotte JP

Subjects
Animals, Ceramides metabolism, Chemical Phenomena, Chemistry, Physical, Cholesterol pharmacology, Hydrolysis, Magnesium metabolism, Membranes, Artificial, Phospholipids pharmacology, Phosphorylcholine, Pressure, Sphingomyelins chemistry, Temperature, Sphingomyelin Phosphodiesterase metabolism, Sphingomyelins metabolism, Staphylococcus aureus enzymology
Abstract

The objective of this study was to define how the quality of the buffer/membrane interface influences the activity of bacterial sphingomyelinase acting at the interface. The enzyme reaction was carried out in a zero-order trough using a surface barostat. This approach allowed for proper control of the physico-chemical properties of the substrate molecules. Since the molecular area of ceramide is smaller than that of sphingomyelin, the hydrolysis reaction could be followed 'on-line' from the monolayer area decrease at constant surface pressure. The hydrolysis reaction could be divided into two separate phases, the first being the lag-phase (time between enzyme addition and commencement of the monolayer area change), and the second phase being the actual hydrolysis reaction (from which a maximal degradation rate could be determined). The activity of sphingomyelinase (Staphylococcus aureus) toward bovine brain sphingomyelin (bb-SM) was markedly enhanced by Mg2+ (maximal activation at 5 mM). Mg2+ also influenced the lag-phase of the reaction (the lag-time increased markedly when the Mg2+ concentration decreased below 1 mM). Saturated sphingomyelins (bb-SM and N-palmitoyl sphingomyelin [N-P-SM]) were more slowly degraded than the mono-unsaturated N-oleoyl sphingomyelin (N-O-SM). Both bb-SM and N-P-SM monolayers underwent a phase-transition at room temperature, whereas the N-O-SM monolayer did not. The phase-transition (liquid-expanded to liquid-condensed) was observed to greatly increase the lag-time of the hydrolysis reaction. The activity of sphingomyelinase was also sensitive to the lateral surface pressure of the monolayer membrane. Maximal degradation rate was achieved at 20 mN/m (with bb-SM, 30 degrees C); above this pressure the lag-time of the reaction increased sharply. The inclusion of 4 mol% of cholesterol into a [3H]sphingomyelin monolayer markedly increased the extent of [3H]sphingomyelin degradation, and shortened the lag-time of the reaction. The inclusion of 10 mol% of zwitterionic or negatively charged phospholipids to the [3H]sphingomyelin monolayer did not affect the sphingomyelinase reaction significantly. In conclusion, this study has demonstrated that the physico-chemical properties of the substrate molecules have a dominating influence on the activity of a bacterial sphingomyelinase acting at the buffer/membrane interface.

Published
1997
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34. Effect of sterol side-chain structure on sterol-phosphatidylcholine interactions in monolayers and small unilamellar vesicles.

Author

Slotte JP, Jungner M, Vilchèze C, and Bittman R

Subjects
1,2-Dipalmitoylphosphatidylcholine chemistry, Cholesterol Oxidase, Membranes, Artificial, Oxidation-Reduction, Structure-Activity Relationship, Phosphatidylcholines chemistry, Sterols chemistry
Abstract

In this study we have characterized the monolayer behavior of analogues of cholesterol having different side-chain structures and their interaction with phosphatidylcholines in mixed monolayers and small unilamellar vesicles (SUVs). Two series of side-chain analogues of cholesterol were synthesized, one with an unbranched side chain (the n-series, from 3 to 7 carbons in length), and the other with a single methyl-branched side chain (the iso-series, from 5 to 10 carbons in length). The length and conformation of the sterol side chain markedly influenced both the mean molecular area of the pure sterols and their monolayer stability (i.e., collapse pressure). Shorter side chains gave smaller mean molecular areas and decreased monolayer stability. The sterols from the n-series also had smaller mean molecular areas than the corresponding sterols in the iso-series. In mixed 1,2-dipalmitoyl-sn-glycero-3-phosphocholine (DPPC)/sterol monolayers (equimolar ratio; at 22 degrees C), all of the sterols tested decreased the monolayer stability as judged by the lower collapse pressure with sterol than without sterol. A similar trend was observed in mixed monolayers containing 1-stearoyl-2-oleoyl-sn-glycero-3-phosphocholine (SOPC), except that sterols from the iso-series with a chain length of 8 or 10 carbon atoms actually stabilized the monolayer compared with the sterol-free SOPC monolayer. The ability of the sterols to condense the molecular packing of DPPC was similar with all sterols (3-5% condensation at 10 mN/m), irrespective of the length or structure of the side chain. 5-Androsten-3 beta-ol, however, which lacks the side chain, did not at all condense the monolayer packing of DPPC. With SOPC mixed monolayers, all side chain containing sterols caused a 18-20% condensation (at 10 mN/m) of monolayer packing. The condensing effect of 5-androsten-3 beta-ol on SOPC packing was again much smaller (about 10%) compared with that of the side-chain sterols. The rate of sterol oxidation by cholesterol oxidase (at 37 degrees C) in DPPC-containing SUVs increased as a function of increasing the side-chain length (iso-series). With sterols from the n-series, the same trend was seen, except that the n-C7 analogue was oxidized much slower than the n-C4, n-C5, and n-C6 analogues. With SOPC SUVs, a similar side-chain dependent oxidation pattern was observed. Our results support and extend previous knowledge about the importance of the sterol side chain in determining sterol-sterol and sterol-phospholipid interactions, both in mono- and bilayers.

Published
1994
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