A prospective observational study of critically ill patients over the age of 50, studying the occurrence of frailty as measured by a variety of frailty measures, processes of care and long term outcomes.
Frailty is common in critically ill elderly patients, and is associated with adverse impacts on outcomes and is becoming increasingly common in Intensive Care Unit (ICU) populations. However it is not clear as to how to best measure frailty and when to do so. It is also not clear as to how processes of care impact on the outcomes observed. We hypothesize that frailty in survivors of critical illness will be measurable at hospital discharge, will correlate with processes of care while in ICU and will better discriminate long term outcomes when compared to severity of illness or the degree of frailty present on ICU admission.
Study Type
OBSERVATIONAL
Enrollment
700
No interventions
University of Alberta
Edmonton, Alberta, Canada
Dalhousie University - QEII
Halifax, Ontario, Canada
St Joe's Hamilton
Hamilton, Ontario, Canada
Kingston Health Sciences Center
Frailty status
Frailty as measured with the Clinical Frailty Scale (CFS). CFS is a 9 point scale with frailty defined as a CFS \> 4 with higher scores indicating greater degrees of frailty.
Time frame: 6 Months
Frailty status
Frailty as measured with the Frailty Index (FI). The FI is indicated by the proportion of deficits present over the number measured and is scored as a fraction between 0 and 1.0. Frailty is considered to be present when the FI is \> 0.20 and the severity of frailty is considered higher with increasing values for the FI.
Time frame: 6 Months
Number of patients with a measure of frailty prior to hospital discharge.
Measure of the Frailty Index and Clinical Frailty Scale prior to discharge
Time frame: 28 days
Correlation of frailty severity at hospital discharge with long term outcomes (mortality, Quality of Life and Need for Institutionalization)
Clinical outcomes at 6 months will include mortality, Quality of Life (EQ5L) and need for Institutionalization
Time frame: 6 months
Impact of admission critical illness on the development and severity of frailty as measured by a Frailty Index or Clinical Frailty Scale
Correlation with the progression or presence of frailty as measured with the Frailty Index or Clinical Frailty Scale
Time frame: 28 days and 6 months
Correlation of ICU processes of care (nutritional adequacy, adverse events, mobilization and sedation) with frailty progression as measured by the Clinical Frailty Scale or Frailty Index
Correlation of processes of care in ICU with frailty progression
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Kingston, Ontario, Canada
London Health Sciences Centre
London, Ontario, Canada
The Ottawa Hospital
Ottawa, Ontario, Canada
Mount Sinai Hospital
Toronto, Ontario, Canada
Laval University
Laval, Quebec, Canada
Hôpital du Sacré-Cœur de Montréal
Montreal, Quebec, Canada
Maisonneuve Rosemont
Montreal, Quebec, Canada
...and 1 more locations
Time frame: 28 days