Frailty is associated with long-term outcome in patients with sepsis who are over 80 years old: results from an observational study in 241 European ICUs

Lenneke Haas , Ariane Boumendil (1) , Hans Flaatten , Bertrand Guidet (2) , Mercedes Ibarz , Christian Jung , Rui Moreno , Alessandro Morandi , Finn Andersen , Tilemachos Zafeiridis , Sten Walther , Sandra Oeyen , Susannah Leaver , Ximena Watson , Carole Boulanger , Wojciech Szczeklik , Joerg Schefold , Maurizio Cecconi , Brian Marsh , Michael Joannidis , Yuriy Nalapko , Muhammed Elhadi , Jesper Fjølner , Antonio Artigas , Dylan de Lange , Michael Joannidis , Philipp Eller , Raimund Helbok , René Schmutz , Joke Nollet , Nikolaas de Neve , Pieter de Buysscher , Sandra Oeyen , Walter Swinnen , Marijana Mikačić , Anders Bastiansen , Andreas Husted , Bård Dahle , Christine Cramer , Christoffer Sølling , Dorthe Ørsnes , Jakob Edelberg Thomsen , Jonas Juul Pedersen , Mathilde Hummelmose Enevoldsen , Thomas Elkmann , Agnieszka Kubisz-Pudelko , Alan Pope , Amy Collins , Ashok Raj , Carole Boulanger , Christian Frey , Ciaran Hart , Clare Bolger , Dominic Spray , Georgina Randell , Helder Filipe , Ingeborg Welters , Irina Grecu , Jane Evans , Jason Cupitt , Jenny Lord , Jeremy Henning , Joanne Jones , Jonathan Ball , Julie North , Kiran Salaunkey , Laura Ortiz-Ruiz de Gordoa , Louise Bell , Madhu Balasubramaniam , Marcela Vizcaychipi , Maria Faulkner , Mcdonald Mupudzi , Megan Lea-Hagerty , Michael Reay , Michael Spivey , Nicholas Love , Nick Spittle Nick Spittle , Nigel White , Patricia Williams , Patrick Morgan , Phillipa Wakefield , Rachel Savine , Reni Jacob , Richard Innes , Ritoo Kapoor , Sally Humphreys , Steve Rose , Susan Dowling , Susannah Leaver , Tarkeshwari Mane , Tom Lawton , Vongayi Ogbeide , Waqas Khaliq , Yolanda Baird , Antoine Romen , Arnaud Galbois , Bertrand Guidet , Christophe Vinsonneau , Cyril Charron , Didier Thevenin , Emmanuel Guerot , Guillaume Besch , Guillaume Savary , Hervé Mentec , Jean-Luc Chagnon , Jean-Philippe Rigaud , Jean-Pierre Quenot , Jeremy Castaneray , Jérémy Rosman , Julien Maizel (3) , Kelly Tiercelet , Lucie Vettoretti , Maud Mousset Hovaere , Messika Messika , Michel Djibré , Nathalie Rolin , Philippe Burtin , Pierre Garcon , Saad Nseir , Xavier Valette , Christian Rabe , Eberhard Barth , Henning Ebelt , Kristina Fuest , Marcus Franz , Michael Horacek , Michael Schuster , Patrick Meybohm , Raphael Romano Bruno , Sebastian Allgäuer , Simon Dubler , Stefan Schaller , Stefan Schering , Stephan Steiner , Thorben Dieck , Tim Rahmel , Tobias Graf , Anastasia Koutsikou , Aristeidis Vakalos , Bogdan Raitsiou , Elli Niki Flioni , Evangelia Neou , Fotios Tsimpoukas , Georgios Papathanakos , Giorgos Marinakis , Ioannis Koutsodimitropoulos , Kounougeri Aikaterini , Nikoletta Rovina , Stylliani Kourelea , Tasioudis Polychronis , Vasiiios Zidianakis , Vryza Konstantinia , Zoi Aidoni , Brian Marsh , Catherine Motherway , Chris Read , Ignacio Martin-Loeches , Andrea Neville Cracchiolo , Aristide Morigi , Italo Calamai , Stefania Brusa , Ahmed Elhadi , Ahmed Tarek , Ala Khaled , Hazem Ahmed , Wesal Ali Belkhair , Alexander Cornet , Diederik Gommers , Dylan de Lange , Eva van Boven , Jasper Haringman , Lenneke Haas , Lettie van den Berg , Oscar Hoiting , Peter de Jager , Rik Gerritsen , Tom Dormans , Willem Dieperink , Alena Breidablik Alena Breidablik , Anita Slapgard , Anne-Karin Rime , Bente Jannestad , Britt Sjøbøe , Eva Rice , Finn Andersen , Hans Frank Strietzel , Jan Peter Jensen , Jørund Langørgen , Kirsti Tøien , Kristian Strand , Michael Hahn , Pål Klepstad , Aleksandra Biernacka , Anna Kluzik , Bartosz Kudlinski , Dariusz Maciejewski , Dorota Studzińska , Hubert Hymczak , Jan Stefaniak , Joanna Solek-Pastuszka , Joanna Zorska , Katarzyna Cwyl , Lukasz Krzych , Maciej Zukowski , Małgorzata Lipińska-Gediga , Marek Pietruszko , Mariusz Piechota , Marta Serwa , Miroslaw Czuczwar , Mirosław Ziętkiewicz , Natalia Kozera , Paweł Nasiłowski , Paweł Sendur , Paweł Zatorski , Piotr Galkin , Ryszard Gawda , Urszula Kościuczuk , Waldemar Cyrankiewicz , Wojciech Gola , Alexandre Fernandes Pinto , Ana Margarida Fernandes , Ana Rita Santos , Cristina Sousa , Inês Barros , Isabel Amorim Ferreira , Jacobo Bacariza Blanco , João Teles Carvalho , Jose Maia , Nuno Candeias , Nuno Catorze , Vladislav Belskiy , Africa Lores , Angela Prado Mira , Catia Cilloniz , David Perez-Torres , Emilio Maseda , Enver Rodriguez , Estefania Prol-Silva , Gaspar Eixarch , Gemma Gomà , Gerardo Aguilar , Gonzalo Navarro Velasco , Marián Irazábal Jaimes , Mercedes Ibarz Villamayor , Noemí Llamas Fernández , Patricia Jimeno Cubero , Sonia López-Cuenca , Teresa Tomasa , Anders Sjöqvist , Camilla Brorsson , Fredrik Schiöler , Henrik Westberg , Jessica Nauska , Joakim Sivik , Johan Berkius , Karin Kleiven Thiringer , Lina de Geer , Sten Walther , Filippo Boroli , Joerg Schefold , Leila Hergafi , Philippe Eckert , Ismail Yıldız , Ihor Yovenko , Yuriy Nalapko , Yuriy Nalapko , Richard Pugh

1 CHU Saint-Antoine [AP-HP]
2 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique
3 MP3CV - Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517

Abstract Background Sepsis is one of the most frequent reasons for acute intensive care unit (ICU) admission of very old patients and mortality rates are high. However, the impact of pre-existing physical and cognitive function on long-term outcome of ICU patients ≥ 80 years old (very old intensive care patients (VIPs)) with sepsis is unclear. Objective To investigate both the short- and long-term mortality of VIPs admitted with sepsis and assess the relation of mortality with pre-existing physical and cognitive function. Design Prospective cohort study. Setting 241 ICUs from 22 European countries in a six-month period between May 2018 and May 2019. Subjects Acutely admitted ICU patients aged ≥80 years with sequential organ failure assessment (SOFA) score ≥ 2. Methods Sepsis was defined according to the sepsis 3.0 criteria. Patients with sepsis as an admission diagnosis were compared with other acutely admitted patients. In addition to patients’ characteristics, disease severity, information about comorbidity and polypharmacy and pre-existing physical and cognitive function were collected. Results Out of 3,596 acutely admitted VIPs with SOFA score ≥ 2, a group of 532 patients with sepsis were compared to other admissions. Predictors for 6-month mortality were age (per 5 years): Hazard ratio (HR, 1.16 (95% confidence interval (CI), 1.09–1.25, P < 0.0001), SOFA (per one-point): HR, 1.16 (95% CI, 1.14–1.17, P < 0.0001) and frailty (CFS > 4): HR, 1.34 (95% CI, 1.18–1.51, P < 0.0001). Conclusions There is substantial long-term mortality in VIPs admitted with sepsis. Frailty, age and disease severity were identified as predictors of long-term mortality in VIPs admitted with sepsis.

Mots clés: frailty; intensive care unit (ICU); mortality; sepsis; very old people

Domaines: Sciences du Vivant [q-bio]

Lenneke Haas, Ariane Boumendil, Hans Flaatten, Bertrand Guidet, Mercedes Ibarz, et al.. Frailty is associated with long-term outcome in patients with sepsis who are over 80 years old: results from an observational study in 241 European ICUs. Age and Ageing, 2021, 50 (5), pp.1719-1727. ⟨10.1093/ageing/afab036⟩. ⟨hal-03921933⟩