The impact of frailty in critically ill patients after trauma: A prospective observational study. Issue 3 (May 2020)

• Record Type: Journal Article
• Authors: Tipping, Claire J.; Bilish, Emily; Harrold, Meg; Holland, Anne E.; Chan, Terry; Hodgson, Carol L.
• Is Part Of: Australian critical care. Volume 33:Issue 3(2020)
• Page Start: 228
• Page End: 235
• Publication Date: 2020-05
• Subjects: Intensive care unit -- Critical illness -- Frailty -- Trauma; Intensive care nursing -- Periodicals; Intensive care nursing -- Australia -- Periodicals; Electronic journals; 616.028
• DOI: 10.1016/j.aucc.2019.11.001
• Languages: English
• ISSNs: 1036-7314

Abstract

Abstract: Background: As our population ages, older adults are increasingly exposed to trauma. Frailty could be a useful measure to identify patients at risk of a poor outcome. This study aimed to determine the impact of frailty in an Australian trauma intensive care unit (ICU) population. Methods: A prospective observational study of critically ill trauma patients ≥50 years of age. Frailty was determined on admission to the ICU using the frailty phenotype. Demographic and hospital data were collected, and patients were followed up at 6 and 12 months. The primary outcome was 12-month mortality, and multiple regression was used to determine associated factors. Results: One hundred thirty-eight patients were included, whose mean age was 68 years; 78.2% (108/138) were classified as major trauma (Injury Severity Score >12). Twenty-two percent (30/138) of patients were identified as frail. Patients with frailty were significantly older: however, they were less severely injured and required lower rates of surgical interventions and mechanical ventilation. Frailty was independently associated with mortality at 6 and 12 months (odds ratio: 5.9, 95% confidence interval: 1.9–18.1 and odds ratio: 7.3, 95% confidence interval: 2.5–21.9, respectively). Patients with frailty had lower measures of global functioning (Glasgow Outcome Scale-Extended frail 3 [1–5] vs nonfrail 6 [(5–7], p = 0.002) and health status (Euro Qol 5Q-5D-5L utility score 0.6 [0.5–0.7] vs 0.7 [0.6–0.9], p = 0.02) at 12 months than patients without frailty. Conclusion: Frailty is a useful predictor of poor outcomes in critically ill trauma patients. Registration of protocol number: ACTRN12615000039583.