Predictors of outcomes of patients ≥ 80 years old admitted to intensive care units in Poland - a post-hoc analysis of the VIP2 prospective observational study.
Paweł Melchior Pasieka, Michał Kurek, Wojciech Skupnik, Evan Skwara, Valentyn Bezshapkin, Jakub Fronczek, Anna Kluzik, Bartosz Kudliński, Szymon Białka, Dorota Studzińska, Łukasz Krzych, Szymon Czajka, Jan Stefaniak, Radosław Owczuk, Joanna Sołek-Pastuszka, Jowita Biernawska, Joanna Zorska, Paweł Krawczyk, Katarzyna Cwyl, Maciej Żukowski, Katarzyna Kotfis, Małgorzata Zegan-Barańska, Agnieszka Wieczorek, Wojciech Mudyna, Mariusz Piechota, Szymon Bernas, Waldemar Machała, Łukasz Sadowski, Marta Serwa, Mirosław Czuczwar, Michał Borys, Mirosław Ziętkiewicz, Natalia Kozera, Barbara Adamik, Waldemar Goździk, Paweł Nasiłowski, Paweł Zatorski, Janusz Trzebicki, Piotr Gałkin, Ryszard Gawda, Urszula Kościuczuk, Waldemar Cyrankiewicz, Katarzyna Sierakowska, Wojciech Gola, Hubert Hymczak, Hans Flaatten, Wojciech Szczeklik
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Abstract
Introduction: Elderly patients pose a significant challenge to intensive care unit (ICU) clinicians. In this study we attempted to characterise the population of patients over 80 years old admitted to ICUs in Poland and identify associations between clinical features and short-term outcomes.
Material and methods: The study is a post-hoc analysis of the Polish cohort of the VIP2 European prospective observational study enrolling patients > 80 years old admitted to ICUs over a 6-month period. Data including clinical features, clinical frailty scale (CFS), geriatric scales, interventions within the ICU, and outcomes (30-day and ICU mortality and length of stay) were gathered. Univariate analyses comparing frail (CFS > 4) to non-frail patients and survivors to non-survivors were performed. Multivariable models with CFS, activities of daily living score (ADL), and the cognitive decline questionnaire IQCODE as predictors and ICU or 30-day mortality as outcomes were formed.
Results: A total of 371 patients from 27 ICUs were enrolled. Frail patients had significantly higher ICU (58% vs. 44.45%, P = 0.03) and 30-day (65.61% vs. 54.14%, P = 0.01) mortality compared to non-frail counterparts. The survivors had significantly lower SOFA score, CFS, ADL, and IQCODE than non-survivors. In multivariable analysis CFS (OR 1.15, 95% CI: 1.00-1.34) and SOFA score (OR 1.29, 95% CI: 1.19-1.41) were identified as significant predictors for ICU mortality; however, CFS was not a predictor for 30-day mortality ( P = 0.07). No statistical significance was found for ADL, IQCODE, polypharmacy, or comorbidities.
Conclusions: We found a positive correlation between CFS and ICU mortality, which might point to the value of assessing the score for every patient admitted to the ICU. The older Polish ICU patients were characterised by higher mortality compared to the other European countries.
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