Top

Published in:

01-12-2017 | Editorial

Frailty in the age of VIPs (very old intensive care patients)

Authors: Carmel Montgomery, Sean M. Bagshaw

Published in: Intensive Care Medicine | Issue 12/2017

Excerpt

Frailty, a multi-system decline in health status resulting from the cumulative impairment of homeostatic reserve (i.e., energy, physical ability, cognition), is increasingly recognized as an important prognostic determinant of outcome among critically ill populations [1‐3]. Frailty predisposes to disproportionate and heightened vulnerability to adverse outcomes from acute stressors such as infection, surgery, or trauma. As many as one-third of adult critically ill patients admitted to the intensive care unit (ICU) have been shown to be screened as frail, with the prevalence increasing with older age [1, 2, 4]. …

Bagshaw SM, Stelfox HT, McDermid RC, Rolfson DB, Tsuyuki RT, Baig N, Artiuch B, Ibrahim Q, Stollery DE, Rokosh E et al (2014) Association between frailty and short- and long-term outcomes among critically ill patients: a multicentre prospective cohort study. CMAJ 186:E95–E102CrossRefPubMedPubMedCentral

Brummel NE, Bell SP, Girard TD, Pandharipande PP, Jackson JC, Morandi A, Thompson JL, Chandrasekhar R, Bernard GR, Dittus RS et al (2017) Frailty and subsequent disability and mortality among patients with critical illness. Am J Respir Crit Care Med 196:64–72CrossRefPubMed

Le Maguet P, Roquilly A, Lasocki S, Asehnoune K, Carise E, Saint Martin M, Mimoz O, Le Gac G, Somme D, Cattenoz C et al (2014) Prevalence and impact of frailty on mortality in elderly ICU patients: a prospective, multicenter, observational study. Intensive Care Med 40:674–682PubMed

Muscedere J, Waters B, Varambally A, Bagshaw SM, Boyd JG, Maslove D, Sibley S, Rockwood K (2017) The impact of frailty on intensive care unit outcomes: a systematic review and meta-analysis. Intensive Care Med 43:1105–1122CrossRefPubMedPubMedCentral

Rockwood K, Song X, Mitnitski A (2011) Changes in relative fitness and frailty across the adult lifespan: evidence from the Canadian National Population Health Survey. CMAJ 183:E487–E494CrossRefPubMedPubMedCentral

Gill TM, Gahbauer EA, Han L, Allore HG (2010) Trajectories of disability in the last year of life. N Engl J Med 362:1173–1180CrossRefPubMedPubMedCentral

Fassbender K, Fainsinger RL, Carson M, Finegan BA (2009) Cost trajectories at the end of life: the Canadian experience. J Pain Symptom Manage 38:75–80CrossRefPubMed

Flaatten H, De Lange DW, Morandi A, Andersen FH, Artigas A, Bertolini G, Boumendil A, Cecconi M, Christensen S, Faraldi L et al (2017) The impact of frailty on ICU and 30-day mortality and the level of care in very elderly patients (≥ 80 years). Intensive Care Med. https://doi.org/10.1007/s00134-017-4940-8

Rockwood K, Song X, MacKnight C, Bergman H, Hogan DB, McDowell I, Mitnitski A (2005) A global clinical measure of fitness and frailty in elderly people. CMAJ 173:489–495CrossRefPubMedPubMedCentral

10.

Iwashyna TJ, Hodgson CL, Pilcher D, Bailey M, van Lint A, Chavan S, Bellomo R (2016) Timing of onset and burden of persistent critical illness in Australia and New Zealand: a retrospective, population-based, observational study. Lancet Respir Med 4:566–573CrossRefPubMed

11.

Muscedere J, Andrew MK, Bagshaw SM, Estabrooks C, Hogan D, Holroyd-Leduc J, Howlett S, Lahey W, Maxwell C, McNally M et al (2016) Screening for frailty in Canada’s Health Care System: a time for action. Can J Aging 35:281–297CrossRefPubMed

Title: Frailty in the age of VIPs (very old intensive care patients)
Authors: Carmel Montgomery
Sean M. Bagshaw
Publication date: 01-12-2017
Publisher: Springer Berlin Heidelberg
Published in: Intensive Care Medicine / Issue 12/2017
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-017-4974-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Frailty in the age of VIPs (very old intensive care patients)

Excerpt

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Excerpt

Please log in to get access to this content

Other articles of this Issue 12/2017

Biomarker-guided antifungal therapy in patients with suspected invasive candidiasis: Ready for prime time?

Discussion on “Opening pressures and atelectrauma in acute respiratory distress syndrome”

ICM focus on thrombosis and bleeding

Combined rupture of left ventricular free wall and pericardium

Guidelines for the diagnosis and management of critical illness-related corticosteroid insufficiency (CIRCI) in critically ill patients (Part I): Society of Critical Care Medicine (SCCM) and European Society of Intensive Care Medicine (ESICM) 2017

Ventilator-associated pneumonia prevention: one good turn does not always deserve another