| Title |
Association between frailty, delirium, and mortality in older critically ill patients: a binational registry study
|
|---|---|
| Published in |
Annals of Intensive Care, November 2022
|
| DOI | 10.1186/s13613-022-01080-y |
| Pubmed ID | |
| Authors |
Berhe W. Sahle, David Pilcher, Edward Litton, Richard Ofori-Asenso, Karlheinz Peter, James McFadyen, Tracey Bucknall |
| Abstract |
Frailty and delirium are prevalent among older adults admitted to the intensive care unit (ICU) and associated with adverse outcomes; however, their relationships have not been extensively explored. This study examined the association between frailty and mortality and length of hospital stay (LOS) in ICU patients, and whether the associations are mediated or modified by an episode of delirium. Retrospective analysis of data from the Australian New Zealand Intensive Care Society Adult Patient Database. A total of 149,320 patients aged 65 years or older admitted to 203 participating ICUs between 1 January 2017 and 31 December 2020 who had data for frailty and delirium were included in the analysis. A total of 41,719 (27.9%) older ICU patients were frail on admission, and 9,179 patients (6.1%) developed delirium during ICU admission. Frail patients had significantly higher odds of in-hospital mortality (OR: 2.15, 95% CI 2.05-2.25), episodes of delirium (OR: 1.86, 95% CI 1.77-1.95), and longer LOS (log-transformed mean difference (MD): 0.24, 95% CI 0.23-0.25). Acute delirium was associated with 32% increased odds of in-hospital mortality (OR: 1.32, 95% CI 1.23-1.43) and longer LOS (MD: 0.54, 95% CI 0.50-0.54). The odds ratios (95% CI) for in-hospital mortality were 1.37 (1.23-1.52), 2.14 (2.04-2.24) and 2.77 (2.51-3.05) for non-frail who developed delirium, frail without delirium, and frail and developed delirium during ICU admission, respectively. There was very small but statistically significant effect of frailty on in-hospital mortality (b for indirect effect: 0.00037, P < 0.001) and LOS (b for indirect effect: 0.019, P < 0.001) mediated through delirium. Both frailty and delirium independently increase the risk of in-hospital mortality and LOS. Acute delirium is more common in frail patients; however, it does not mediate or modify a clinically meaningful amount of the association between frailty and in-hospital mortality and LOS. |
X Demographics
The data shown below were collected from the profiles of 29 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 4 | 14% |
| United States | 4 | 14% |
| Spain | 2 | 7% |
| Argentina | 2 | 7% |
| Japan | 1 | 3% |
| Portugal | 1 | 3% |
| France | 1 | 3% |
| Ireland | 1 | 3% |
| Australia | 1 | 3% |
| Other | 0 | 0% |
| Unknown | 12 | 41% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 22 | 76% |
| Practitioners (doctors, other healthcare professionals) | 3 | 10% |
| Scientists | 2 | 7% |
| Science communicators (journalists, bloggers, editors) | 2 | 7% |
Mendeley readers
The data shown below were compiled from readership statistics for 23 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 23 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 2 | 9% |
| Professor | 1 | 4% |
| Other | 1 | 4% |
| Student > Master | 1 | 4% |
| Student > Ph. D. Student | 1 | 4% |
| Other | 0 | 0% |
| Unknown | 17 | 74% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 2 | 9% |
| Nursing and Health Professions | 2 | 9% |
| Business, Management and Accounting | 1 | 4% |
| Social Sciences | 1 | 4% |
| Engineering | 1 | 4% |
| Other | 0 | 0% |
| Unknown | 16 | 70% |
Attention Score in Context
This research output has an Altmetric Attention Score of 22. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 08 March 2023.
All research outputs
#1,719,567
of 25,448,590 outputs
Outputs from Annals of Intensive Care
#205
of 1,199 outputs
Outputs of similar age
#37,268
of 491,070 outputs
Outputs of similar age from Annals of Intensive Care
#9
of 30 outputs
Altmetric has tracked 25,448,590 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 93rd percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,199 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 18.2. This one has done well, scoring higher than 82% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 491,070 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 92% of its contemporaries.
We're also able to compare this research output to 30 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 73% of its contemporaries.