The association of the Activities of Daily Living and the outcome of old intensive care patients suffering from COVID-19.

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State: Public
Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_23D30CED4C10
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
The association of the Activities of Daily Living and the outcome of old intensive care patients suffering from COVID-19.
Journal
Annals of intensive care
Author(s)
Bruno R.R., Wernly B., Flaatten H., Fjølner J., Artigas A., Baldia P.H., Binneboessel S., Bollen Pinto B., Schefold J.C., Wolff G., Kelm M., Beil M., Sviri S., van Heerden P.V., Szczeklik W., Elhadi M., Joannidis M., Oeyen S., Kondili E., Marsh B., Wollborn J., Andersen F.H., Moreno R., Leaver S., Boumendil A., De Lange D.W., Guidet B., Jung C.
Working group(s)
COVIP study group
Contributor(s)
Eller P., Joannidis M., Mesotten D., Reper P., Oeyen S., Swinnen W., Serck N., Dewaele E., Brix H., Brushoej J., Kumar P., Nedergaard H.K., Balleby I.R., Bundesen C., Hansen M.A., Uhrenholt S., Bundgaard H., Fjølner J., Gooch J., Cagova L., Potter E., Reay M., Davey M., Abusayed M.A., Humphreys S., Galbois A., Guidet B., Charron C., Berlemont C.H., Besch G., Rigaud J.P., Maizel J., Djibré M., Burtin P., Garcon P., Nseir S., Valette X., Alexandru N., Marin N., Vaissiere M., Plantefeve G., Vanderlinden T., Jurcisin I., Megarbane B., Chousterman B.G., Dépret F., Garnier M., Besset S., Oziel J., Ferre A., Dauger S., Dumas G., Goncalves B., Vettoretti L., Thevenin D., Schaller S., Kurt M., Faltlhauser A., Meyer C., Milovanovic M., Lutz M., Shala G., Haake H., Randerath W., Kunstein A., Meybohm P., Steiner S., Barth E., Poerner T., Simon P., Lorenz M., Dindane Z., Kuhn K.F., Welte M., Voigt I., Kabitz H.J., Wollborn J., Goebel U., Stoll S.E., Kindgen-Milles D., Dubler S., Jung C., Fuest K., Schuster M., Papadogoulas A., Mulita F., Rovina N., Aidoni Z., Chrisanthopoulou E., Kondili E., Andrianopoulos I., Groenendijk M., Evers M., van Lelyveld-Haas L., Meynaar I., Cornet A.D., Zegers M., Dieperink W., De Lange D.W., Dormans T., Hahn M., Sjøbøe B., Strietzel H.F., Olasveengen T., Romundstad L., Andersen F.H., Kluzik A., Zatorski P., Drygalski T., Szczeklik W., Klimkiewicz J., Solek-Pastuszka J., Onichimowski D., Czuczwar M., Gawda R., Stefaniak J., Stefanska-Wronka K., Zabul E., Oliveira AIP, Assis R., de Lurdes Campos Santos M., Santos H., Cardoso F.S., Gordinho A., Banzo MJA, Zalba-Etayo B., Cubero P.P., Priego J., Gomà G., Tomasa-Irriguible T.M., Sancho S., Ferreira A.F., Vázquez E.M., Mira Á.P., Ibarz M., Iglesias D., Arias-Rivera S., Frutos-Vivar F., Lopez-Cuenca S., Aldecoa C., Perez-Torres D., Canas-Perez I., Tamayo-Lomas L., Diaz-Rodriguez C., de Gopegui P.R., Ben-Hamouda N., Roberti A., Fleury Y., Abidi N., Schefold J.C., Chau I., Dullenkopf A., Pugh R., Smuts S.
ISSN
2110-5820 (Print)
ISSN-L
2110-5820
Publication state
Published
Issued date
18/03/2022
Peer-reviewed
Oui
Volume
12
Number
1
Pages
26
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Critically ill old intensive care unit (ICU) patients suffering from Sars-CoV-2 disease (COVID-19) are at increased risk for adverse outcomes. This post hoc analysis investigates the association of the Activities of Daily Living (ADL) with the outcome in this vulnerable patient group.
The COVIP study is a prospective international observational study that recruited ICU patients ≥ 70 years admitted with COVID-19 (NCT04321265). Several parameters including ADL (ADL; 0 = disability, 6 = no disability), Clinical Frailty Scale (CFS), SOFA score, intensive care treatment, ICU- and 3-month survival were recorded. A mixed-effects Weibull proportional hazard regression analyses for 3-month mortality adjusted for multiple confounders.
This pre-specified analysis included 2359 patients with a documented ADL and CFS. Most patients evidenced independence in their daily living before hospital admission (80% with ADL = 6). Patients with no frailty and no disability showed the lowest, patients with frailty (CFS ≥ 5) and disability (ADL < 6) the highest 3-month mortality (52 vs. 78%, p < 0.001). ADL was independently associated with 3-month mortality (ADL as a continuous variable: aHR 0.88 (95% CI 0.82-0.94, p < 0.001). Being "disable" resulted in a significant increased risk for 3-month mortality (aHR 1.53 (95% CI 1.19-1.97, p 0.001) even after adjustment for multiple confounders.
Baseline Activities of Daily Living (ADL) on admission provides additional information for outcome prediction, although most critically ill old intensive care patients suffering from COVID-19 had no restriction in their ADL prior to ICU admission. Combining frailty and disability identifies a subgroup with particularly high mortality.
NCT04321265.
Pubmed
Create date
19/03/2022 19:58
Last modification date
23/11/2022 7:09
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