Evidence map›Paper›PMID 28263377›Full record

ArticleJournal of the American Geriatrics Society2017

The Frailty Phenotype and Palliative Care Needs of Older Survivors of Critical Illness.

Lauren R Pollack, Nathan E Goldstein, Wendy C Gonzalez, Craig D Blinderman, Mathew S Maurer, David J Lederer, Matthew R Baldwin

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Geriatrics Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Lauren R PollackDepartment of Medicine, College of Physicians & Surgeons, Columbia University, New York, New York.
Nathan E GoldsteinMount Sinai Beth Israel, Division of Palliative Care, Icahn School of Medicine at Mount Sinai, New York, New York.
Wendy C GonzalezDepartment of Medicine, College of Physicians & Surgeons, Columbia University, New York, New York.
Craig D BlindermanDepartment of Medicine, College of Physicians & Surgeons, Columbia University, New York, New York.
Mathew S MaurerDepartment of Medicine, College of Physicians & Surgeons, Columbia University, New York, New York.
David J LedererDepartment of Medicine, College of Physicians & Surgeons, Columbia University, New York, New York.
Matthew R BaldwinDepartment of Medicine, College of Physicians & Surgeons, Columbia University, New York, New York.

Funding

Clinical and Translational Science AwardUL1TR000040 · NCATS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI GINSBERG, HENRY N · 2012 to 2015
$26.2M
Pilot CoreP30AG022845 · NIA · WEILL MEDICAL COLL OF CORNELL UNIV · PI Manney Carrington Reid · 2003 to 2026
$15.2M
Clinical and Translational Science AwardKL2TR000081 · NCATS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI GINSBERG, HENRY N · 2012 to 2015
$3.3M
Obesity, Inflammation, and Lung Injury After Lung TransplantationR01HL114626 · NHLBI · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI CHRISTIE, JASON D, LEDERER, DAVID J. · 2013 to 2016
$3.1M
Midcareer Mentoring Award for Patient Oriented Research in Geriatric CardiologyK24AG036778 · NIA · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI MAURER, MATHEW S · 2010 to 2020
$1.6M
Frailty, Palliative Care Needs, and Outcomes in Older Survivors of Critical IllneK23AG045560 · NIA · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI BALDWIN, MATTHEW R · 2014 to 2018
$750k
Mentored Patient Oriented Research in Pulmonary Fibrosis and Lung TransplantationK24HL131937 · NHLBI · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI LEDERER, DAVID J. · 2016 to 2018
$352k
NCATS NIH HHS KL2 TR000081NCATS NIH HHS UL1 TR000040NHLBI NIH HHS K24 HL131937NHLBI NIH HHS R01 HL114626NIA NIH HHS K23 AG045560NIA NIH HHS K24 AG036778NIA NIH HHS L30 AG040838NIA NIH HHS P30 AG022845
6 · The paper itself

Abstract

objectivesTo assess symptoms in older intensive care unit (ICU) survivors and determine whether post-ICU frailty identifies those with the greatest palliative care needs.

designA prospective cohort study.

settingUrban tertiary care hospital and community hospital.

participantsMedical ICU survivors of mechanical ventilation aged 65 and older (N = 125). MEASUREMENTS: Baseline measurements of the Edmonton Symptom Assessment Scale (ESAS), categorized as mild (0-3), moderate (4-6), and severe (7-10), and the frailty phenotype were made during the week before hospital discharge. Functional recovery was defined as a return to a Katz activity of daily living dependency count less than or equal to the prehospitalization dependency count within 3 months. In the last 29 participants recruited, we made additional assessments of fatigue and ESAS both at baseline and 1 month after discharge.

resultsFatigue was the most-prevalent moderate to severe symptom (74%), followed by dyspnea (53%), drowsiness (50%), poor appetite (47%), pain (45%), depression (42%), anxiety (36%), and nausea (17%). At 1-month follow-up, there were no significant differences in the proportions of participants with moderate to severe symptoms. Each increase in baseline ESAS fatigue severity category was associated with 55% lower odds of functional recovery (odds ratio = 0.45, 95% confidence interval = 0.24-0.84), independent of age, sex, comorbidities, and critical illness severity. Frail participants had a higher median baseline total ESAS symptom distress score (34, interquartile range (IQR) 23-44) than nonfrail participants (13, IQR 9-22) (P < .001).

conclusionOlder ICU survivors have a high burden of palliative care needs that persist 1 month after discharge. Fatigue is the most-prevalent symptom and may interfere with recovery. Post-ICU frailty may be a useful trigger for palliative care consultation and a treatment target.

Indexed as

Critical IllnessFrail ElderlyPhenotypeAdvance DirectivesAftercareAgedFatigueFemaleHumansIntensive Care UnitsMaleNeeds AssessmentPalliative CareSkilled Nursing FacilitiesSurveys and QuestionnairesSurvivorscritical carefatiguefrailtypalliative care

Identifiers

PMID28263377
PMCPMC5478496

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.