ArticleCritical care (London, England)2021
Frailty status among older critically ill patients with severe acute kidney injury.
Article in Critical care (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 26 citations in OpenAlex.
- Frailty in Focus: A Scoping Review of Frailty Instruments from the Kidney Disease Aging Research Collaborative.Clinical journal of the American Society of Nephrology : CJASN · 2026Article
- Genetic and metabolomic pathways linking frailty, chronic kidney disease, and kidney failure: a Mendelian randomization and multi-omics analysis.Renal failure · 2025Article
- Association between a laboratory-based frailty index and mortality of critically ill patients with acute pancreatitis: a retrospective study.Frontiers in nutrition · 2025Article
- The association between frailty and the risk of mortality in critically ill congestive heart failure patients: findings from the MIMIC-IV database.Frontiers in endocrinology · 2024Article
- Frailty Is Associated With Decreased Survival in Adult Patients With Nonoperative and Operative Traumatic Subdural Hemorrhage: A Retrospective Cohort Study of 381,754 Patients.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2023Article
- Survive or thrive after ICU: what's the score?Annals of intensive care · 2023Article
- The impact of frailty on in-hospital complications in elderly patients with acute coronary syndrome.Journal of geriatric cardiology : JGC · 2023Article
- Utility of frailty as a predictor of acute kidney injury in patients with aneurysmal subarachnoid hemorrhage.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2023Article
- Frailty is a stronger predictor of death in younger intensive care patients than in older patients: a prospective observational study.Annals of intensive care · 2022Article
- Frailty is associated with poor prognosis after resection for pancreatic cancer.International journal of clinical oncology · 2021Article
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundFrailty status among critically ill patients with acute kidney injury (AKI) is not well described despite its importance for prognostication and informed decision-making on life-sustaining therapies. In this study, we aim to describe the epidemiology of frailty in a cohort of older critically ill patients with severe AKI, the outcomes of patients with pre-existing frailty before AKI and the factors associated with a worsening frailty status among survivors.
methodsThis was a secondary analysis of a prospective multicentre observational study that enrolled older (age > 65 years) critically ill patients with AKI. The clinical frailty scale (CFS) score was captured at baseline, at 6 months and at 12 months among survivors. Frailty was defined as a CFS score of ≥ 5. Demographic, clinical and physiological variables associated with frailty as baseline were described. Multivariable Cox proportional hazard models were constructed to describe the association between frailty and 90-day mortality. Demographic and clinical factors associated with worsening frailty status at 6 months and 12 months were described using multivariable logistic regression analysis and multistate models.
resultsAmong the 462 patients in our cohort, median (IQR) baseline CFS score was 4 (3-5), with 141 (31%) patients considered frail. Pre-existing frailty was associated with greater hazard of 90-day mortality (59% (n = 83) for frail vs. 31% (n = 100) for non-frail; adjusted hazards ratio [HR] 1.49; 95% CI 1.11-2.01, p = 0.008). At 6 months, 68 patients (28% of survivors) were frail. Of these, 57% (n = 39) were not classified as frail at baseline. Between 6 and 12 months of follow-up, 9 (4% of survivors) patients transitioned from a frail to a not frail status while 10 (4% of survivors) patients became frail and 11 (5% of survivors) patients died. In multivariable analysis, age was independently associated with worsening CFS score from baseline to 6 months (adjusted odds ratio [OR] 1.08; 95% CI 1.03-1.13, p = 0.003).
conclusionsPre-existing frailty is an independent risk factor for mortality among older critically ill patients with severe AKI. A substantial proportion of survivors experience declining function and worsened frailty status within one year.
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