Mortality in Relation to Frailty in Patients Admitted to a Specialized Geriatric Intensive Care Unit
Open accessAbstract
BACKGROUND: In older adults admitted to intensive care units (ICUs), frailty influences prognosis. We examined the relationship between the frailty index (FI) based on deficit accumulation and early and late survival. METHODS: Older patients (≥65 years) admitted to a specialized geriatric ICU at the Liuhuaqiao Hospital, Guangzhou, China between July-December 2011 (n = 155; age 82.7±7.1 y; 87.1% men) were followed for 300 days. The FI was calculated as the proportion present of 52 health deficits. FI performance was compared with that of several prognostic scores. RESULTS: The 90-day death rate was 38.7% (n = 60; 27 died within 30 days). The FI score was correlated with the Glasgow Coma Scale, Karnofsky Scale, Palliative Performance Scale, Acute Physiology Score-APACHE II and APACHE IV (r (2) = 0.52 to 0.72, p < 0.001). Patients who died within 30 days had higher mean FI scores (0.41±0.11) than those who survived to 300 days (0.22±0.11; F = 38.91, p < 0.001). Each 1% increase in the FI from the previous level was associated with an 11% increase in the 30-day mortality risk (95% CI: 7%-15%) adjusting for age, sex, and the prognostic scores. The FI discriminated patients who died in 30 days from those who survived with moderately high accuracy (AUC = 0.89±0.03). No one with an FI score >0.46 survived past 90 days. CONCLUSION: ICU survival was strongly associated with the level of frailty at admission. An FI based on health deficit accumulation may help improve critical care outcome prediction in older adults.
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The CGA is now being used more widely in clinical trials and practice.
“is now being used more widely in clinical trials and in practice (25,26)”
From Frailty as determined by a comprehensive geriatric assessment-derived deficit-accumulation index in older patients with cancer who receive chemotherapy (2016) · cites this paper as [25]
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- Authors
- Zeng, A., Song, X., Dong, J., Mitnitski, A., Liu, J., Guo, Z., & Rockwood, K.
- Affiliations
- Guangdong University of Technology (CN)
- Dalhousie University (CA)
- General Hospital of Guangzhou Military Command (CN)
- Corresponding author
- Guo, Zhenhui
- Venue
- The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
- Publisher
- Oxford University Press (OUP)
- Published
- 2015-09-22
- Volume
- 70
- Issue
- 12
- Pages
- 1586-1594
- ISSN
- 1079-5006 (ISSN-L)
- 1758-535X
- PMC
- PMC4631107
- OpenAlex
- W2180667378
- Cited by
- 96
- References
- 46
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 3 · 2023: 4 · 2022: 9 · 2021: 17 · 2020: 11 · 2019: 5 · 2018: 15 · 2017: 17 · 2016: 10 · 2015: 1
- FWCI
- 7.16
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- The Journals of Gerontology Series A (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Funders
- National Natural Science Foundation of China (61300107, 59976016)
- Natural Science Foundation of Guangdong Province (S2012010010212)
- Canadian Institutes of Health Research (CCI92216)
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Keywords
- frailty, frailty index, older adults, geriatric intensive care, mortality, 30-day mortality, health deficits, prognostic score, Apache, APACHE II score, APACHE IV, survival prediction, critical care outcomes
- MeSH terms
- Aged, 80 and over, Female, Humans, Intensive Care Units, Male, Patient Admission, Prospective Studies, Geriatric Assessment, Frail Elderly, Hospital Mortality
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