TY - JOUR
T1 - Association of frailty on treatment outcomes among patients with suspected infection treated at emergency departments
AU - Ishikawa, Shigeto
AU - Miyagawa, Ippei
AU - Kusanaga, Masashi
AU - Abe, Toshikazu
AU - Shiraishi, Atsushi
AU - Fujishima, Seitaro
AU - Ogura, Hiroshi
AU - Saitoh, Daizoh
AU - Kushimoto, Shigeki
AU - Shiino, Yasukazu
AU - Hifumi, Toru
AU - Otomo, Yasuhiro
AU - Okamoto, Kohji
AU - Kotani, Joji
AU - Sakamoto, Yuichiro
AU - Sasaki, Junichi
AU - Shiraishi, Shin Ichiro
AU - Takuma, Kiyotsugu
AU - Hagiwara, Akiyoshi
AU - Yamakawa, Kazuma
AU - Takeyama, Naoshi
AU - Gando, Satoshi
AU - Mayumi, Toshihiko
N1 - Funding Information:
The authors thank the study participants, without whom this study would never have been accomplished, as well as the investigators for their participation in the study. The SPICE-ER study and the current study were funded by the Japanese Association for Acute Medicine (JAAM). The funders (except for JAAM itself) had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript and decision to submit the manuscript for publication.
Publisher Copyright:
© 2021 Lippincott Williams and Wilkins. All rights reserved.
PY - 2021/8/1
Y1 - 2021/8/1
N2 - Background The clinical frailty scale (CFS) score has been validated as a predictor of adverse outcomes in community-dwelling older people. Older people are at a higher risk of sepsis and have a higher mortality rate. However, the association of frailty on outcomes in patients with sepsis has not been completely examined. Objective This study evaluated the association between CFS and outcomes in patients with sepsis. Design This was a multicenter prospective cohort substudy. Settings and participants The study included 37 emergency departments from across Japan. The patients (age ≥16 years) were included in this study if they had suspected infection at an emergency department during December 2017-February 2018. Outcome measure and analysis The primary outcome was 28-day mortality, stratified by the CFS score categories. The secondary outcomes were the duration of hospital stay, number of ICU-free days (ICUFDs) and number of ventilator-free days (VFDs). Main results A total of 917 patients were included. The median age was 79 years. The CFS score was associated with an increased risk of 28-day mortality and with a higher likelihood of long-term hospital stay and short-term VFDs and ICUFDs. Multivariate logistic regression analysis indicated that the CFS score was a predictor of 28-day mortality [odds ratio (OR), 1.26; 95% confidence interval (CI), 1.11-1.42]. Conclusions This study reported that in patients with suspected sepsis in the emergency department, frailty may be associated with poor prognosis and length of hospital stay.
AB - Background The clinical frailty scale (CFS) score has been validated as a predictor of adverse outcomes in community-dwelling older people. Older people are at a higher risk of sepsis and have a higher mortality rate. However, the association of frailty on outcomes in patients with sepsis has not been completely examined. Objective This study evaluated the association between CFS and outcomes in patients with sepsis. Design This was a multicenter prospective cohort substudy. Settings and participants The study included 37 emergency departments from across Japan. The patients (age ≥16 years) were included in this study if they had suspected infection at an emergency department during December 2017-February 2018. Outcome measure and analysis The primary outcome was 28-day mortality, stratified by the CFS score categories. The secondary outcomes were the duration of hospital stay, number of ICU-free days (ICUFDs) and number of ventilator-free days (VFDs). Main results A total of 917 patients were included. The median age was 79 years. The CFS score was associated with an increased risk of 28-day mortality and with a higher likelihood of long-term hospital stay and short-term VFDs and ICUFDs. Multivariate logistic regression analysis indicated that the CFS score was a predictor of 28-day mortality [odds ratio (OR), 1.26; 95% confidence interval (CI), 1.11-1.42]. Conclusions This study reported that in patients with suspected sepsis in the emergency department, frailty may be associated with poor prognosis and length of hospital stay.
KW - clinical frailty scale
KW - frailty
KW - infection
KW - sepsis
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U2 - 10.1097/MEJ.0000000000000788
DO - 10.1097/MEJ.0000000000000788
M3 - Article
C2 - 34187992
AN - SCOPUS:85109321253
SN - 0969-9546
VL - 28
SP - 285
EP - 291
JO - European Journal of Emergency Medicine
JF - European Journal of Emergency Medicine
IS - 4
ER -