| Objective: To describe the prevalence of frailty in elderly critically ill patients admitted to ICU,and explore the impact of frailty on clinical diagnosis and treatment and short-term prognosis of elderly critically ill patients admitted to ICU.Methods: In this study,a prospective study method was adopted to collect the clinical data of elderly critically ill patients admitted to ICU in Zunyi Medical University Affiliated Hospital from November 2020 to November 2021,including general demographic characteristics,comorbidities,main ICU diagnoses,and Clinical Frailty Scale Score(CFS),Charlson Comorbidity Index(CCI),Acute Physiology and Chronic Health Status Scoring System II(APACHE II),Sequential Organ Failure Score(SOFA);complications,vasoactive drugs,hormones,blood transfusion,blood decontamination,mechanical ventilation,mechanical ventilation time,ICU length of stay,total hospital stay,total medical expenses,ICU mortality,in-hospital mortality,30-day mortality and other clinical data.Primary outcome measures: 30-day mortality;secondary outcome measures: ICU mortality,in-hospital mortality.According to the Clinical Frailty Scale Score,the patients were divided into frail group(≥5 points)and non-frailty group(<5points).The clinical characteristics and clinical outcomes of ICU were compared between the two groups.Then,an equal-proportional-hazards Cox regression model was used to analyze the effect of frailty on the short-term prognosis of elderly critically ill patients admitted to ICU,A P < 0.05 was considered to be statistically significant.Results:1.A total of 212 patients were finally included in this study,with a median age of71(66,78)years,including123 male(58.02%)and 89 females(41.98%);There were 51cases(24.06%)in the frail group,and 28 cases(54.90%)were male;161 cases(75.94%)were in the non-frail group,and 95 cases(59.01%)were male.There was statistically significant differences between the frail group and the non-frail group in terms of age[77(69,82)vs.70(65.5,77),P=0.001],diabetes(35.29% vs.15.53%,P=0.003),chronic obstructive pulmonary disease(25.49 % vs.11.80%,P=0.024),cerebrovascular disease(39.22% vs.19.25%,P=0.005),CCI[3(1,5)vs.1(0.5,3),P=0.001] and APACHE II score[23(19,30)vs.20(15,25),P=0.001] and major ICU diagnoses.2.Incidence of respiratory failure(39.22% vs.17.39%,P=0.002),dobutamine(5.88% vs.0.62%,P=0.044),and mechanical ventilation(80.39% vs.62.11,P=0.017)between frail and non-frail groups,the difference was statistically significant;.The ICU mortality,in-hospital mortality,and 30-day mortality in the frail group were 21.57%,25.49%,and 29.41%,respectively,higher than those in the non-frail group,4.35%,6.21%,and 8.70%(P=0.001).3.Cox regression univariate analysis showed that age,frailty,major ICU diagnosis,APACHE II,SOFA score,respiratory failure,and vasoactive drugs were associated with all-cause mortality(P<0.05).The variables with meaningful univariate analysis results were subjected to stepwise regression and included in the Cox regression multivariate model,and the results showed that frailty was an independent risk factor for death in elderly critically ill patients admitted to ICU.The risk of death was 2.7 times that of patients without frailty(HR=2.766,95%CI 1.303-5.872;P=0.008).Conclusion:1.The prevalence of frailty in elderly critically ill patients admitted to ICU was24.06%,and the prevalence of frailty increases with age.2.Compared with the non-frail group,the frail group of elderly critically ill patients admitted to ICU were more likely to have comorbidities such as diabetes,chronic obstructive pulmonary disease,and cerebrovascular disease.3.The severity of illness(APACHE II),incidence of respiratory failure,use of mechanical ventilation,in-hospital mortality,and ICU mortality in frail elderly critically ill patients admitted to ICU were higher than non-frail elderly critically ill patients admitted to ICU.4.Frailty is an independent risk factor for death in ICU elderly critically ill patients. |
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