Prevalence of frailty  and association with patient centered outcomes: A prospective registry-embedded cohort study from India

IRIS collaborative; Bharath Kumar Tirupakuzhi Vijayaraghavan; Aasiyah Rashan; Swagata Tripathy; Devachandran Jayakumar; Ramesh  Venkataraman; Pratheema Ramachandran; Zubair Umer  Mohamed; Sindhu  Balakrishnan; Nagarajan  Ramakrishnan; Rashan Haniffa; Abi Beane; Neill K.J. Adhikari; Nicolette F De Keizer; Nazir I Lone

doi:10.1016/j.jcrc.2023.154509

Prevalence of frailty and association with patient centered outcomes: A prospective registry-embedded cohort study from India

IRIS collaborative, Bharath Kumar Tirupakuzhi Vijayaraghavan^*, Aasiyah Rashan, Swagata Tripathy, Devachandran Jayakumar, Ramesh Venkataraman, Pratheema Ramachandran, Zubair Umer Mohamed, Sindhu Balakrishnan, Nagarajan Ramakrishnan, Rashan Haniffa, Abi Beane, Neill K.J. Adhikari, Nicolette F De Keizer, Nazir I Lone

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

Purpose:
We aimed to study the prevalence of frailty, evaluate risk factors, and understand impact on outcomes in India.
Methods:
This was a prospective registry-embedded cohort study across 7 intensive care units (ICUs) and included adult patients anticipated to stay for at least 48hrs. Primary exposure was frailty, as defined by a score ≥5 on the Clinical Frailty Scale and primary outcome was ICU mortality. Secondary outcomes included in-hospital mortality and resource utilization. We used generalized linear models to evaluate risk factors and model association between frailty and outcomes.
Results:
838 patients were included, with median (IQR) age 57 (42,68) yrs.; 64.8% were male. Prevalence of frailty was 19.8%. Charlson comorbidity index (OR:1.73 (95%CI:1.39,2.15)), Subjective Global Assessment categories mild/moderate malnourishment (OR:1.90 (95%CI:1.29, 2.80)) and severe malnourishment [OR:4.76 (95% CI:2.10,10.77)] were associated with frailty. Frailty was associated with higher odds of ICU mortality (adjusted OR:2.04 (95% CI:1.25,3.33)), hospital mortality (adjusted OR:2.36 (95%CI:1.45,3.84)), development of stage2/3 AKI (unadjusted OR:2.35 (95%CI:1.60, 3.43)), receipt of non-invasive ventilation (unadjusted OR:2.68 (95%CI:1.77, 4.03)), receipt of vasopressors (unadjusted OR:1.47 (95%CI:1.04, 2.07)), and receipt of kidney replacement therapy (unadjusted OR:3.15 (95%CI:1.90, 5.17)).
Conclusions:
Frailty is common among critically ill patients in India and is associated with worse outcomes.

Original language	English
Article number	154509
Number of pages	7
Journal	Journal of Critical Care
Volume	80
Early online date	21 Dec 2023
DOIs	https://doi.org/10.1016/j.jcrc.2023.154509
Publication status	Published - 1 Apr 2024

Keywords / Materials (for Non-textual outputs)

Frailty
Intensive Care Units
Registries
Global Health
Developing Countries

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IRIS collaborative, Tirupakuzhi Vijayaraghavan, B. K., Rashan, A., Tripathy, S., Jayakumar, D., Venkataraman, R., Ramachandran, P., Mohamed, Z. U., Balakrishnan, S., Ramakrishnan, N., Haniffa, R., Beane, A., Adhikari, N. K. J., De Keizer, N. F., & Lone, N. I. (2024). Prevalence of frailty and association with patient centered outcomes: A prospective registry-embedded cohort study from India. Journal of Critical Care, 80, Article 154509. https://doi.org/10.1016/j.jcrc.2023.154509

@article{e647a4770a9b4209bdb6c21d9a05c86d,

title = "Prevalence of frailty and association with patient centered outcomes: A prospective registry-embedded cohort study from India",

abstract = "Purpose:We aimed to study the prevalence of frailty, evaluate risk factors, and understand impact on outcomes in India. Methods:This was a prospective registry-embedded cohort study across 7 intensive care units (ICUs) and included adult patients anticipated to stay for at least 48hrs. Primary exposure was frailty, as defined by a score ≥5 on the Clinical Frailty Scale and primary outcome was ICU mortality. Secondary outcomes included in-hospital mortality and resource utilization. We used generalized linear models to evaluate risk factors and model association between frailty and outcomes. Results:838 patients were included, with median (IQR) age 57 (42,68) yrs.; 64.8% were male. Prevalence of frailty was 19.8%. Charlson comorbidity index (OR:1.73 (95%CI:1.39,2.15)), Subjective Global Assessment categories mild/moderate malnourishment (OR:1.90 (95%CI:1.29, 2.80)) and severe malnourishment [OR:4.76 (95% CI:2.10,10.77)] were associated with frailty. Frailty was associated with higher odds of ICU mortality (adjusted OR:2.04 (95% CI:1.25,3.33)), hospital mortality (adjusted OR:2.36 (95%CI:1.45,3.84)), development of stage2/3 AKI (unadjusted OR:2.35 (95%CI:1.60, 3.43)), receipt of non-invasive ventilation (unadjusted OR:2.68 (95%CI:1.77, 4.03)), receipt of vasopressors (unadjusted OR:1.47 (95%CI:1.04, 2.07)), and receipt of kidney replacement therapy (unadjusted OR:3.15 (95%CI:1.90, 5.17)). Conclusions:Frailty is common among critically ill patients in India and is associated with worse outcomes. ",

keywords = "Frailty, Intensive Care Units, Registries, Global Health, Developing Countries",

author = "{IRIS collaborative} and {Tirupakuzhi Vijayaraghavan}, {Bharath Kumar} and Aasiyah Rashan and Swagata Tripathy and Devachandran Jayakumar and Ramesh Venkataraman and Pratheema Ramachandran and Mohamed, {Zubair Umer} and Sindhu Balakrishnan and Nagarajan Ramakrishnan and Rashan Haniffa and Abi Beane and Adhikari, {Neill K.J.} and {De Keizer}, {Nicolette F} and Lone, {Nazir I}",

note = "This research was funded in part, by the Wellcome Trust [Grant number WT215522/Z/19/Z]. For the purpose of open access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. The funder had no role in the design, conduct, analysis or the decision to submit for publication.",

year = "2024",

month = apr,

day = "1",

doi = "10.1016/j.jcrc.2023.154509",

language = "English",

volume = "80",

journal = "Journal of Critical Care",

issn = "0883-9441",

publisher = "Elsevier",

}

IRIS collaborative, Tirupakuzhi Vijayaraghavan, BK, Rashan, A, Tripathy, S, Jayakumar, D, Venkataraman, R, Ramachandran, P, Mohamed, ZU, Balakrishnan, S, Ramakrishnan, N, Haniffa, R , Beane, A, Adhikari, NKJ, De Keizer, NF & Lone, NI 2024, 'Prevalence of frailty and association with patient centered outcomes: A prospective registry-embedded cohort study from India', Journal of Critical Care, vol. 80, 154509. https://doi.org/10.1016/j.jcrc.2023.154509

TY - JOUR

T1 - Prevalence of frailty and association with patient centered outcomes

T2 - A prospective registry-embedded cohort study from India

AU - IRIS collaborative

AU - Tirupakuzhi Vijayaraghavan, Bharath Kumar

AU - Rashan, Aasiyah

AU - Tripathy, Swagata

AU - Jayakumar, Devachandran

AU - Venkataraman, Ramesh

AU - Ramachandran, Pratheema

AU - Mohamed, Zubair Umer

AU - Balakrishnan, Sindhu

AU - Ramakrishnan, Nagarajan

AU - Haniffa, Rashan

AU - Beane, Abi

AU - Adhikari, Neill K.J.

AU - De Keizer, Nicolette F

AU - Lone, Nazir I

N1 - This research was funded in part, by the Wellcome Trust [Grant number WT215522/Z/19/Z]. For the purpose of open access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. The funder had no role in the design, conduct, analysis or the decision to submit for publication.

PY - 2024/4/1

Y1 - 2024/4/1

N2 - Purpose:We aimed to study the prevalence of frailty, evaluate risk factors, and understand impact on outcomes in India. Methods:This was a prospective registry-embedded cohort study across 7 intensive care units (ICUs) and included adult patients anticipated to stay for at least 48hrs. Primary exposure was frailty, as defined by a score ≥5 on the Clinical Frailty Scale and primary outcome was ICU mortality. Secondary outcomes included in-hospital mortality and resource utilization. We used generalized linear models to evaluate risk factors and model association between frailty and outcomes. Results:838 patients were included, with median (IQR) age 57 (42,68) yrs.; 64.8% were male. Prevalence of frailty was 19.8%. Charlson comorbidity index (OR:1.73 (95%CI:1.39,2.15)), Subjective Global Assessment categories mild/moderate malnourishment (OR:1.90 (95%CI:1.29, 2.80)) and severe malnourishment [OR:4.76 (95% CI:2.10,10.77)] were associated with frailty. Frailty was associated with higher odds of ICU mortality (adjusted OR:2.04 (95% CI:1.25,3.33)), hospital mortality (adjusted OR:2.36 (95%CI:1.45,3.84)), development of stage2/3 AKI (unadjusted OR:2.35 (95%CI:1.60, 3.43)), receipt of non-invasive ventilation (unadjusted OR:2.68 (95%CI:1.77, 4.03)), receipt of vasopressors (unadjusted OR:1.47 (95%CI:1.04, 2.07)), and receipt of kidney replacement therapy (unadjusted OR:3.15 (95%CI:1.90, 5.17)). Conclusions:Frailty is common among critically ill patients in India and is associated with worse outcomes.

AB - Purpose:We aimed to study the prevalence of frailty, evaluate risk factors, and understand impact on outcomes in India. Methods:This was a prospective registry-embedded cohort study across 7 intensive care units (ICUs) and included adult patients anticipated to stay for at least 48hrs. Primary exposure was frailty, as defined by a score ≥5 on the Clinical Frailty Scale and primary outcome was ICU mortality. Secondary outcomes included in-hospital mortality and resource utilization. We used generalized linear models to evaluate risk factors and model association between frailty and outcomes. Results:838 patients were included, with median (IQR) age 57 (42,68) yrs.; 64.8% were male. Prevalence of frailty was 19.8%. Charlson comorbidity index (OR:1.73 (95%CI:1.39,2.15)), Subjective Global Assessment categories mild/moderate malnourishment (OR:1.90 (95%CI:1.29, 2.80)) and severe malnourishment [OR:4.76 (95% CI:2.10,10.77)] were associated with frailty. Frailty was associated with higher odds of ICU mortality (adjusted OR:2.04 (95% CI:1.25,3.33)), hospital mortality (adjusted OR:2.36 (95%CI:1.45,3.84)), development of stage2/3 AKI (unadjusted OR:2.35 (95%CI:1.60, 3.43)), receipt of non-invasive ventilation (unadjusted OR:2.68 (95%CI:1.77, 4.03)), receipt of vasopressors (unadjusted OR:1.47 (95%CI:1.04, 2.07)), and receipt of kidney replacement therapy (unadjusted OR:3.15 (95%CI:1.90, 5.17)). Conclusions:Frailty is common among critically ill patients in India and is associated with worse outcomes.

KW - Frailty

KW - Intensive Care Units

KW - Registries

KW - Global Health

KW - Developing Countries

U2 - 10.1016/j.jcrc.2023.154509

DO - 10.1016/j.jcrc.2023.154509

M3 - Article

SN - 0883-9441

VL - 80

JO - Journal of Critical Care

JF - Journal of Critical Care

M1 - 154509

ER -

Prevalence of frailty and association with patient centered outcomes: A prospective registry-embedded cohort study from India

Abstract

Keywords / Materials (for Non-textual outputs)

Access to Document

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