La “fragilità†come fattore predittivo degli esiti conseguenti al ricovero in un reparto semintensivo. Uno studio pilota.

Ricevuto: 17 gennaio 2018
Accettato: 17 gennaio 2018
Pubblicato: 17 gennaio 2018
Abstract Views: 191
PDF: 18
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Obiettivo: i soggetti fragili che subiscono un evento critico sono a elevato rischio di esiti avversi anche quando sopravvivono al ricovero. In ambito critico la condizione di fragilità viene raramente diagnosticata. L’obiettivo dello studio è di analizzare gli esiti del ricovero in una struttura semintensiva in una popolazione di pazienti fragili e identificare le variabili predittive di esito avverso.



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United nations department of economics and social affairs. Demographic Yearbook 64th issue. 2013;64:1–912.
mUsso cG, Vilas m, de QUirós fG, núñez Jf. The importance of evaluating frailty and social-behavioral factors for managing drugs and dialysis
prescription in elderly patients. Drug Res (Stuttg) 2015 Nov 17. [Epub ahead of print]
marenGoni a, anGleman s, melis r, manGialasche f, Karp a, Garmen a, meinow B, fratiGlioni l. Aging with multimorbidity: a systematic review of the
literature. Ageing Res Rev 2011;10:430–9.
morley Je, Vellas B, aBellan Van Kan G, anKer sd, BaUer Jm, BernaBei r, walston J. Frailty consensus: a call to action. J Am Med Dir Assoc 2013;14(6):392-7.
chanG sf, lin pl. Frail phenotype and mortality prediction: A systematic review and meta-analysis of prospective cohort studies. Int J Nurs Stud 2015;52(8):1362-74.
shamliyan t, talley Km, ramaKrishnan r, Kane rl. Association of frailty with survival: a systematic literature review. Ageing Res Rev 2013;12(2):719-36.
tUrner G, cleGG a. Best practice guidelines for the management of frailty: a British Geriatrics Society, Age UK and Royal College of General
Practitioners report. Age Ageing 2014;43(6):744-7.
rowan Km, JenKinson c, BlacK n. Health-related quality of life. In: Surviving ICU. Carlet AD (Ed). London, UK, Springer, 2003, pp 35–50
capUzzo m, Bianconi m. Our paper 20 years later: 1-year survival and 6-month quality of life after intensive care. Intensive Care Med 2015;41(4):605-14.
BoUmendil a, somme d, GarroUste-orGeas m, GUidet B. Should elderly patients be admitted to the intensive care unit? Intensive Care Med 2007;33(7):1252-62.
BoUmendil a, maUry e, reinhard i, lUQUel l, offenstadt G, GUidet B. Prognosis of patients aged 80 years and over admitted in medical intensive care unit. Intensive Care Med. 2004;30(4):647-54.
Baldwin mr, narain wr, wUnsch h, schlUGer nw, cooKe Jt, maUrer ms, rowe Jw, lederer dJ, Bach pB. A prognostic model for 6-month mortality in elderly survivors of critical illness. Chest 2013;143(4):910-9.
ho Km, KnUiman m, finn J, weBB sa. Estimating long-term survival of critically ill patients: the PREDICT model. PLoS One 2008;3(9):e3226.
world health orGanization (WHO). International Statistical Classi cation of Diseases and Related Health Problems, 10th Revision. Available on cations/icd10/browse/2015/en Last access: 3/6/2015
KnaUs wa, waGner dp, zimmerman Je, draper ea. Variations in mortality and length of stay in intensive care units. Ann Int Med 1993;118:753:61.
Bannay a, chaiGnot c, Blotière po, Basson m, weill a, ricordeaU p, alla f. The best use of the Charlson Comorbidity Index with electronic health care database to predict mortality. Med Care 2016;54(2):188-94.
charlson me, szatrowsKi tp, peterson J, Gold J. Validation of a combined comorbidity index. J Clin Epidemiol 1994;47(11):1245-51.
mahoney fi, Barthel dw. Functional evaluation: The Barthel Index. Md State Med J 1965;14:61e5.
sUperVía a, aranda d, márQUez ma, aGUirre a, sKaf e, GUtiérrez J. Predicting length of hospitalisation of elderly patients, using the Barthel Index. Age Ageing. 2008;37(3):339-42.
lawton mp, Brody em. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969;9:179e86.
Bernardi d, milan i, Balzarotti m, et al. Comprehensive geriatric evaluation in elderly patients with lymphoma: Feasibility of a patient-tailored treatment plan. J Clin Oncol 2003. 21:754.
zenG a, sonG X, donG J, mitnitsKi a, liU J, GUo z, rocKwood K. Mortality in relation to frailty in patients admitted to a specialized geriatric Intensive
Care Unit. J Gerontol A Biol Sci Med Sci 2015;70(12):1586-94.
GrUppo di stUdio Bioetica. Grandi insuf cienze d’organo “end stageâ€: cure intensive or cure palliative? Documento condiviso per una piani cazione delle scelte di cura. 2013. Disponibile su cienze%20d%20organo/ INSUFFICIENZE_CRONICHE_END.pdf Ultimo accesso: 21/11/2015
cheUnG K, oemar m, oppe m, raBin r. EQ-5D. Disponibile su: leadmin/user_upload/Documenten/PDF/User_Guide_v2_ March_2009.pdf Ultimo accesso 22/6/2015
zanini a, aiello m, adamo d, casale s, cherUBino f, della patrona s, raimondi e, zampoGna e, chetta a, spaneVello a. Estimation of minimal clinically important difference in EQ-5D visual analog scale score after pulmonary rehabilitation in subjects with COPD. Respir Care 2015;60(1):88-95.
person sd, allison JJ, Kiefe ci, weaVer mt, williams od, centor rm, et al. Nurse staf ng and mortality for Medicare patients with acute myocardial infarction. Medical care 2004;42(1):4-12.
BUUrman Bm, Van mUnster Bc, KoreVaar Jc, de haan rJ, de rooiJ se. Variability in measuring (instrumental) activities of daily living functioning and functional decline in hospitalized older medical patients: a systematic review. J Clin Epidemiol 2011;64(6):619-27.
Barnato ae, alBert sm, anGUs dc, laVe Jr, deGenholtz hB. Disability among elderly survivors of mechanical ventilation. Am J Respir Crit Care Med. 2011;183(8):1037–42.
BrinKman s, de JonGe e, aBU-hanna a, arBoUs ms, de lanGe dw, de Keizer nf. Mortality after hospital discharge in ICU patients. Crit Care Med 2013;41(5):1229-36.
BaGshaw sm, stelfoX ht, Johnson Ja, mcdermid rc, rolfson dB, tsUyUKi rt, iBrahim Q, maJUmdar sr. Long-term association between frailty and health- related quality of life among survivors of critical illness: a prospective multicenter cohort study. Crit Care Med 2015;43:973-82.
BaGshaw sm, stelfoX ht, mcdermid rc, rolfson dB, tsUyUKi rt, BaiG n, artiUch B, iBrahim Q, stollery de, roKosh e, maJUmdar sr. Association between frailty and short- and long-term outcomes among critically ill patients: a multicentre prospective cohort study. CMAJ 2014;186(2):E95-102.
hofhUis JG, spronK pe, Van stel hf, schriJVers aJ, BaKKer J. Quality of life before intensive care unit admission is a predictor of survival. Crit Care 2007;11:78–9.
BUKan ri, møller am, henninG ma, mortensen KB, KlaUsen tw, waldaU t. Preadmission quality of life can predict mortality in intensive care unit--a prospective cohort study. J Crit Care 2014;29(6):942-7.
caterino Jm, mUrden ra, steVenson KB. Functional status does not predict complicated clinical course in older adults in the emergency department with infection. J Am Geriatr Soc 2012;60(2):304-9.
decoUrcelle V, maréchaUX s, pinçon c, Barrailler s, le Jemtel th, ennezat pV. Impact of functional decline on outcome in elderly patients with acute coronary syndromes. Am J Crit Care 2013;22(1):e1-11.
GarroUste-orGeas m, carlet J. Predicting whether the ICU can help older patients: score needed. Critical Care 2005;9:331-2.
alBrecht Gl, deVlieGer pJ. The disability paradox: high quality of life against all odds. Soc Sci Med 1999;48(8):977-88.
carr aJ, hiGGinson iJ. Are quality of life measures patient-centered? BMJ 2001;322(7298):1357-60.
fricK s, UehlinGer de, zUercher zenKlUsen rm. Medical futility: predicting outcome of intensive care unit patients by nurses and doctors - a prospective comparative study. Crit Care Med 2003;31(2):456-61.
american academy of nUrsinG’s eXpert panel on acUte and critical care. Reducing functional decline in older adults during hospitalization: a best practice approach. Medsurg Nurs 2014;23(4):264-5.

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