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@article{Guidet:2019:10.1007/s00134-019-05853-1,
author = {Guidet, B and de, Lange DW and Boumendil, A and Leaver, S and Watson, X and Boulanger, C and Szczeklik, W and Artigas, A and Morandi, A and Andersen, F and Zafeiridis, T and Jung, C and Moreno, R and Walther, S and Oeyen, S and Schefold, JC and Cecconi, M and Marsh, B and Joannidis, M and Nalapko, Y and Elhadi, M and Fjolner, J and Flaatten, H},
doi = {10.1007/s00134-019-05853-1},
journal = {Intensive Care Medicine},
pages = {57--69},
title = {The contribution of frailty, cognition, activity of daily life and comorbidities on outcome in acutely admitted patients over 80 years in European ICUs: the VIP2 study},
url = {http://dx.doi.org/10.1007/s00134-019-05853-1},
volume = {46},
year = {2019}
}

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TY  - JOUR
AB  - PurposePremorbid conditions affect prognosis of acutely-ill aged patients. Several lines of evidence suggest geriatric syndromes need to be assessed but little is known on their relative effect on the 30-day survival after ICU admission. The primary aim of this study was to describe the prevalence of frailty, cognition decline and activity of daily life in addition to the presence of comorbidity and polypharmacy and to assess their influence on 30-day survival.MethodsProspective cohort study with 242 ICUs from 22 countries. Patients 80 years or above acutely admitted over a six months period to an ICU between May 2018 and May 2019 were included. In addition to common patients’ characteristics and disease severity, we collected information on specific geriatric syndromes as potential predictive factors for 30-day survival, frailty (Clinical Frailty scale) with a CFS > 4 defining frail patients, cognitive impairment (informant questionnaire on cognitive decline in the elderly (IQCODE) with IQCODE ≥ 3.5 defining cognitive decline, and disability (measured the activity of daily life with the Katz index) with ADL ≤ 4 defining disability. A Principal Component Analysis to identify co-linearity between geriatric syndromes was performed and from this a multivariable model was built with all geriatric information or only one: CFS, IQCODE or ADL. Akaike’s information criterion across imputations was used to evaluate the goodness of fit of our models.ResultsWe included 3920 patients with a median age of 84 years (IQR: 81–87), 53.3% males). 80% received at least one organ support. The median ICU length of stay was 3.88 days (IQR: 1.83–8). The ICU and 30-day survival were 72.5% and 61.2% respectively. The geriatric conditions were median (IQR): CFS: 4 (3–6); IQCODE: 3.19 (3–3.69); ADL: 6 (4–6); Comorbidity and Polypharmacy score (CPS): 10 (7–14). CFS, ADL and IQCODE were closely co
AU  - Guidet,B
AU  - de,Lange DW
AU  - Boumendil,A
AU  - Leaver,S
AU  - Watson,X
AU  - Boulanger,C
AU  - Szczeklik,W
AU  - Artigas,A
AU  - Morandi,A
AU  - Andersen,F
AU  - Zafeiridis,T
AU  - Jung,C
AU  - Moreno,R
AU  - Walther,S
AU  - Oeyen,S
AU  - Schefold,JC
AU  - Cecconi,M
AU  - Marsh,B
AU  - Joannidis,M
AU  - Nalapko,Y
AU  - Elhadi,M
AU  - Fjolner,J
AU  - Flaatten,H
DO  - 10.1007/s00134-019-05853-1
EP  - 69
PY  - 2019///
SN  - 0342-4642
SP  - 57
TI  - The contribution of frailty, cognition, activity of daily life and comorbidities on outcome in acutely admitted patients over 80 years in European ICUs: the VIP2 study
T2  - Intensive Care Medicine
UR  - http://dx.doi.org/10.1007/s00134-019-05853-1
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000499414900002&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://link.springer.com/article/10.1007%2Fs00134-019-05853-1
VL  - 46
ER  -

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