Montgomery Carmel L, Davenport Andrea, Milovanovic Lazar, Bagshaw Sean M, Rolfson Darryl B, Rewa Oleksa G
Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton.
Department of Critical Care Medicine, Faculty of Medicine and Dentistry, College of Health Sciences, University of Alberta and Alberta Health Services, Edmonton.
Can Geriatr J. 2024 Sep 5;27(3):307-316. doi: 10.5770/cgj.27.731. eCollection 2024 Sep.
Pre-admission frailty has been associated with higher hospital mortality in patients with critical illness. We aimed to measure the prevalence of frailty and its associated outcomes in patients with COVID-19 critical illness.
A historical cohort study of all adults admitted to ICU with a pneumonia diagnosis in Alberta, Canada between May 1, 2020, and October 31, 2020. At ICU admission patients were routinely assessed for frailty using the Clinical Frailty Scale (CFS). Frailty was defined as a CFS score ≥5. Primary outcomes were pre-admission frailty prevalence and hospital mortality.
The cohort (n=521) prevalence of frailty was 34.2% (n=178), mean (SD) age was 58.8 (14.9) years, APACHE II 22.8 (8.0), and 39.5% (n=206) were female. COVID-19 pneumonia was diagnosed in (19.0%; n=99) admissions; pre-admission frailty was present in 20.2% (n=20) vs. 79.8% (n=79) non-frail (<.001). Among ICU patients admitted with COVID-19, hospital mortality in frail patients was 35.4% (n=63) vs. 14.0% (n=48) in non-frail (<.001).
Pre-admission frailty was present in 20.2% of COVID-19 ICU admissions and was associated with higher risk of hospital mortality. Frailty assessment may yield valuable prognostic information when considering COVID-19 ICU admission; however, further study is needed to identify effect on patient-centred outcomes in this heterogeneous population.
入院前虚弱与危重症患者较高的医院死亡率相关。我们旨在测量新冠肺炎危重症患者中虚弱的患病率及其相关结局。
对2020年5月1日至2020年10月31日期间加拿大艾伯塔省所有因肺炎诊断入住重症监护病房（ICU）的成年人进行一项历史性队列研究。在ICU入院时，使用临床虚弱量表（CFS）对患者进行常规虚弱评估。虚弱定义为CFS评分≥5。主要结局是入院前虚弱患病率和医院死亡率。
队列（n = 521）中虚弱患病率为34.2%（n = 178），平均（标准差）年龄为58.8（14.9）岁，急性生理与慢性健康状况评分系统II（APACHE II）评分为22.8（8.0），女性占39.5%（n = 2�6）。19.0%（n = 99）的入院患者被诊断为新冠肺炎肺炎；入院前虚弱患者占20.2%（n = 20），非虚弱患者占79.8%（n = 79）（P <.001）。在因新冠肺炎入住ICU的患者中，虚弱患者的医院死亡率为35.4%（n = 63），非虚弱患者为14.0%（n = 48）（P <.001）。
20.2%的新冠肺炎ICU入院患者存在入院前虚弱，且与较高的医院死亡风险相关。在考虑新冠肺炎ICU入院时，虚弱评估可能会产生有价值的预后信息；然而，需要进一步研究以确定对这一异质性人群以患者为中心的结局的影响。
