Mohammad Hamidi1, Muhammad Zeeshan2, Valeria Leon-Risemberg3, Janko Nikolich-Zugich4, Kamil Hanna5, Narong Kulvatunyou6, Abdul Tawab Saljuqi7, Mindy Fain8, Bellal Joseph9. 1. Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, United States. Electronic address: hamidi@surgery.arizona.edu. 2. Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, United States. Electronic address: mzeeshan@surgery.arizona.edu. 3. The University of Arizona College of Medicine, Tucson, United States. Electronic address: vleon06@email.arizona.edu. 4. Department of Immunobiology College of Medicine, University of Arizona, Tucson, AZ, United States. Electronic address: nikolich@email.arizona.edu. 5. Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, United States. Electronic address: kamilhanna@surgery.arizona.edu. 6. Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, United States. Electronic address: nkulvatunyou@surgery.arizona.edu. 7. Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, United States. Electronic address: tsaljuqi@surgery.arizona.edu. 8. Section of Geriatrics, General Internal Medicine and Palliative Medicine, University of Arizona, Tucson, AZ, United States. Electronic address: mfain@aging.arizona.edu. 9. Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, United States. Electronic address: bjoseph@surgery.arizona.edu.
Abstract
BACKGROUND: Frailty is highly prevalent in the elderly and confers high risk for adverse outcomes. We aimed to assess the impact of frailty on critically ill older adult trauma patients. METHODS: We analyzed the ACS-TQIP(2010-2014) including all critically-ill trauma patients ≥65y. The modified frailty index (mFI) was calculated. Following stratified into frail and non-frail, propensity score matching was performed. Our primary outcome measure was in-hospital complications. Secondary outcome measures included mortality and discharge disposition. RESULTS: We identified 88,629 patients, of which 34,854 patients (frail: 17,427, non-frail: 17,427) were matched. Overall 14% died. Frail patients had higher rates of complications (34% vs. 18%, p < 0.001), mortality (18.1% vs. 9.7%, p < 0.001), and were more likely to be discharged to rehab/SNF (58.7% vs. 21.2% p < 0.001) compared to non-frail patients. CONCLUSION: critically-ill frail patients are more likely to have higher morbidity and mortality. Frailty can be used as an objective measure to identify high-risk patients.
BACKGROUND: Frailty is highly prevalent in the elderly and confers high risk for adverse outcomes. We aimed to assess the impact of frailty on critically ill older adult traumapatients. METHODS: We analyzed the ACS-TQIP(2010-2014) including all critically-ill traumapatients ≥65y. The modified frailty index (mFI) was calculated. Following stratified into frail and non-frail, propensity score matching was performed. Our primary outcome measure was in-hospital complications. Secondary outcome measures included mortality and discharge disposition. RESULTS: We identified 88,629 patients, of which 34,854 patients (frail: 17,427, non-frail: 17,427) were matched. Overall 14% died. Frail patients had higher rates of complications (34% vs. 18%, p < 0.001), mortality (18.1% vs. 9.7%, p < 0.001), and were more likely to be discharged to rehab/SNF (58.7% vs. 21.2% p < 0.001) compared to non-frail patients. CONCLUSION:critically-ill frail patients are more likely to have higher morbidity and mortality. Frailty can be used as an objective measure to identify high-risk patients.
Authors: Alisha Lussiez; John R Montgomery; Naveen F Sangji; Zhaohui Fan; Bryant W Oliphant; Mark R Hemmila; Justin B Dimick; John W Scott Journal: J Trauma Acute Care Surg Date: 2021-08-01 Impact factor: 3.697
Authors: Shawn Tejiram; Julia Cartwright; Sandra L Taylor; Victor H Hatcher; Colette Galet; Dionne A Skeete; Kathleen S Romanowski Journal: J Surg Res Date: 2020-09-02 Impact factor: 2.192
Authors: Lindsay K Haines; Allyson C Cook; Justin S Hatchimonji; Vanessa P Ho; Elle L Kalbfell; Kathleen M O'Connell; Jacinta C Robenstine; Mathias Schlögl; Christine C Toevs; Christopher A Jones; Robert S Krouse; Niels D Martin Journal: J Palliat Med Date: 2021-07 Impact factor: 2.947