Impact of frailty on critical care and hospital mortality in critically-ill patients with decompensated alcoholic liver disease
Published Date: 26th June 2019
Publication Authors: Tridente A
Introduction
We aimed to assess the effect of frailty as assessed by Clinical Frailty Scale (CFS) and Karnofsky performance score (KPS) on critical care (CC) and hospital mortality in this group at a non-specialist tertiary critical care unit.
Methods
Patients admitted to critical care were identified from our electronic database by screening for liver disease or cirrhosis in the admission diagnoses. Those with an aetiology of liver disease other than alcoholic liver disease (ALD) were excluded. Data was collected on patient demographics, length of stay, status at discharge from critical care and hospital and CFS. KPS was also calculated where sufficient in-formation was available in the medical record. Data was analysed using logistic regression multivariate analysis with Stata 14 software.
Results
A total of 146 patients were identified from our database between December 2011 and Feb 2017. The median (IQR) age was 51 (43-59), and 83 (56%) were male. Mean length of CC stay was 4.9 days and hospital length of stay was 21 days. Overall critical care mortality was 40.4% and hospital mortality was 55.5%. SOFA and increasing frailty as assessed by KPS correlates with increasing critical care mortality, Odds ratio (OR) 0.8, CI 0.70-0.93 p=0.003 for SOFA and OR 1.04, CI 1.01-1.08 p=0.009 for KPS and also for hospital mortality, OR 0.81 CI 0.70-0.93 p value=0.004 for SOFA and OR 1.04CI 1.01-1.08, p=0.011 KPS respectively.
Conclusions
SOFA and increasing frailty, as assessed by KPS, in patients with decompensated ALD correlates with an increase in critical care and hospital mortality.
Pedder, A; Harrold, R; Cruikshanks, A; Tridente, A; Raithatha, A. (2019). P256 Impact of frailty on critical care and hospital mortality in critically-ill patients with decompensated alcoholic liver disease . Critical Care. 23 (S2), 110-111
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