Prognostic Score in the Very Old ICU Patients

Conditions

Aged, 80 and Over, Critical Care

Keywords

Outcome, Survival, Prognostication

Brief summary

The two main aims of the study: 1. To investigate the relation of Frailty, Activity of daily life (ADL), Cognitive functions and Co-morbidity on survival at 30 days (and 6 months in a substudy) 2. From the results design a prognostic score that will be validated using a subpopulation of the study cohort Two secondary aims a 1. Survival at 6 months (in a subpopulation of the study) 2. An inter-rater validation of the Clinical Frailty Score (CFS) (in a subpopulation) Substudies are planned with regards to the different admission categories, in particular: * trauma * acute respiratory failure * sepsis * combined respiratory and circulatory failure * medical neurological conditions In some of the substudies similar groups from the VIP1 study that uses the same admission categories (except planned admissions) will be merged.

Detailed description

Frailty to be registered by the Clinical Frailty Scale (CFS), 1-9 point Activity of Daily life (ADL) with Katz ADL form: 0-6 points Cognition to be described by Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) questionaire, 16 questions to be asked the care-givers Co-morbidity by listing the major comorbidity with Yes or No (Yes= 1 point) and with the number of regular drugs prescribed

de Lange DW, Soliman IW, Leaver S, Boumendil A, Haas LEM, Watson X, Boulanger C, Szczeklik W, Artigas A, Morandi A, Andersen F, Jung C, Moreno R, Walther S, Oeyen S, Schefold JC, Cecconi M, Marsh B, Joannidis M, Nalapko Y, Elhadi M, Fjølner J, Guidet B, Flaatten H, VIP2 study group.

2024-03-305 citations

10.1186/s13613-024-01246-w

The role of clinical phenotypes in decisions to limit life-sustaining treatment for very old patients in the ICU.

Mousai O, Tafoureau L, Yovell T, Flaatten H, Guidet B, Beil M, de Lange D, Leaver S, Szczeklik W, Fjolner J, Nachshon A, van Heerden PV, Joskowicz L, Jung C, Hyams G, Sviri S.

2023-05-1015 citations

10.1186/s13613-023-01136-7

Contribution of information about acute and geriatric characteristics to decisions about life-sustaining treatment for old patients in intensive care.

Beil M, van Heerden PV, de Lange DW, Szczeklik W, Leaver S, Guidet B, Flaatten H, Jung C, Sviri S, Joskowicz L.

2023-01-069 citations

10.1186/s12911-022-02094-z

Management and outcomes in critically ill nonagenarian versus octogenarian patients.

Bruno RR, Wernly B, Kelm M, Boumendil A, Morandi A, Andersen FH, Artigas A, Finazzi S, Cecconi M, Christensen S, Faraldi L, Lichtenauer M, Muessig JM, Marsh B, Moreno R, Oeyen S, Öhman CA, Pinto BB, Soliman IW, Szczeklik W, Valentin A, Watson X, Leaver S, Boulanger C, Walther S, Schefold JC, Joannidis M, Nalapko Y, Elhadi M, Fjølner J, Zafeiridis T, De Lange DW, Guidet B, Flaatten H, Jung C, VIP2 study group.

2021-10-1920 citations

10.1186/s12877-021-02476-4

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

Fronczek J, Polok K, de Lange DW, Jung C, Beil M, Rhodes A, Fjølner J, Górka J, Andersen FH, Artigas A, Cecconi M, Christensen S, Joannidis M, Leaver S, Marsh B, Morandi A, Moreno R, Oeyen S, Agvald-Öhman C, Bollen Pinto B, Schefold JC, Valentin A, Walther S, Watson X, Zafeiridis T, Sviri S, van Heerden PV, Flaatten H, Guidet B, Szczeklik W, VIP1, VIP2 study group.

2021-07-0136 citations

10.1186/s13054-021-03632-3

Provision of critical care for the elderly in Europe: a retrospective comparison of national healthcare frameworks in intensive care units

Bernhard Wernly, Michael Beil, Raphael Romano Bruno, Stephan Binnebößel, Malte Kelm et al. (25 authors)

BMJ Open2021-06-0114 citations

10.1136/bmjopen-2020-046909

Sex-specific outcome disparities in very old patients admitted to intensive care medicine: a propensity matched analysis.

Wernly B, Bruno RR, Kelm M, Boumendil A, Morandi A, Andersen FH, Artigas A, Finazzi S, Cecconi M, Christensen S, Faraldi L, Lichtenauer M, Muessig JM, Marsh B, Moreno R, Oeyen S, Öhman CA, Pinto BB, Soliman IW, Szczeklik W, Niederseer D, Valentin A, Watson X, Leaver S, Boulanger C, Walther S, Schefold JC, Joannidis M, Nalapko Y, Elhadi M, Fjølner J, Zafeiridis T, De Lange DW, Guidet B, Flaatten H, Jung C.

2020-10-2911 citations

10.1038/s41598-020-74910-3

Interventions

OTHERCognitive assesment, Frailty assessment

Asking relatives (using a structured questionaire) about cognitive function at admission , likewise about frailty using the Clinical Frailty Score

Study design

Observational model

COHORT

Time perspective

PROSPECTIVE

Eligibility

Sex/Gender

ALL

Age

80 Years to No maximum

Healthy volunteers

No

Inclusion criteria

* ≥80 admitted to an ICU as an emergency case

Exclusion criteria

* elective admissions

Design outcomes

Primary

Measure	Time frame	Description
30 days survival	30 days	Proportion alive after 30 days

Secondary

Measure	Time frame	Description
Developement of a prognostic score	6 months	Developement and subsequent validation of a prognostic score from data revealed in the study: Frailty, Comorbidity, Activity of Daily life and Cognition. This score is non-existent at the moment, it is a score we will develope and test within the cohort-. No further description can be given before study is finished and analysed.
6 months survival	6 months	Proportion alive after 6 months
Inter-rater validation of Clinical Frailty Scale (CFS)	At admission	The CFS is a simple visual scale of frailty from 1 to 9 (increasing frailty). We will in a subset of our patients use two raters to perform frailty score and compare their results using inter-rater variability tests.

Other

Measure	Time frame	Description
Survival analysis in pre-defined subgroups: Admission categories, use of therapeutic procedures, end-of-life desicion	Up to 6 months	Proportions alive after 30 days and 6 months

Countries

Norway

Outcome results

None listed