Evidence map›Paper›PMID 38871280›Full record

ArticleChest2024

Resilience, Survival, and Functional Independence in Older Adults Facing Critical Illness.

Julien Cobert, Sun Young Jeon, John Boscardin, Allyson C Chapman, Edie Espejo, Jason H Maley, Sei Lee, Alexander K Smith

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Chest, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
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

8 authors.

Julien CobertAnesthesia Service, San Francisco VA Health Care System, San Francisco, CA; Department of Anesthesiology, University of California San Francisco, San Francisco, CA. Electronic address: Julien.cobert@ucsf.edu.
Sun Young JeonDivision of Geriatrics, Department of Medicine, University of California San Francisco, San Francisco, CA; Geriatrics, Palliative, and Extended Care, Veterans Affairs Medical Center, San Francisco, CA.
John BoscardinDivision of Geriatrics, Department of Medicine, University of California San Francisco, San Francisco, CA; Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA; Geriatrics, Palliative, and Extended Care, Veterans Affairs Medical Center, San Francisco, CA.
Allyson C ChapmanCritical Care and Palliative Medicine, Department of Internal Medicine, University of California San Francisco, San Francisco, CA; Department of Surgery, University of California San Francisco, San Francisco, CA.
Edie EspejoDivision of Geriatrics, Department of Medicine, University of California San Francisco, San Francisco, CA; Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA; Geriatrics, Palliative, and Extended Care, Veterans Affairs Medical Center, San Francisco, CA.
Jason H MaleyDivision of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
Sei LeeDivision of Geriatrics, Department of Medicine, University of California San Francisco, San Francisco, CA; Geriatrics, Palliative, and Extended Care, Veterans Affairs Medical Center, San Francisco, CA.
Alexander K SmithDivision of Geriatrics, Department of Medicine, University of California San Francisco, San Francisco, CA; Geriatrics, Palliative, and Extended Care, Veterans Affairs Medical Center, San Francisco, CA.

Funding

Unnecessary and Harmful Medication Use in Older Adults with DementiaP01AG066605 · NIA · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI MELISSA Diane ALDRIDGE · 2020 to 2026
$17.7M
Mentoring Researchers in Prognosis Research in Alzheimer’s Disease and Related DementiasK24AG068312 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Alexander Keliimoeanu Smith · 2020 to 2026
$1.2M
Mentoring Patient-Oriented Research to Individualize Care for Hospitalized Older Adults with and without Alzheimer's Disease and Related DementiasK24AG066998 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Sei Lee · 2021 to 2026
$1.1M
NIA NIH HHS K24 AG066998NIA NIH HHS K24 AG068312NIA NIH HHS P01 AG066605
6 · The paper itself

Abstract

backgroundOlder adults surviving critical illness often experience new or worsening functional impairments. Modifiable positive psychological constructs such as resilience may mitigate post-intensive care morbidity. RESEARCH QUESTION: Is pre-ICU resilience associated with: (1) post-ICU survival; (2) the drop in functional independence during the ICU stay; or (3) the trend in predicted independence before vs after the ICU stay? STUDY DESIGN AND

methodsThis retrospective cohort study was performed by using Medicare-linked Health and Retirement Study surveys from 2006 to 2018. Older adults aged ≥ 65 years admitted to an ICU were included. Resilience was calculated prior to ICU admission. The resilience measure was defined from the Simplified Resilience Score, which was previously adapted and validated for the Health and Retirement Study. Resilience was scored by using the Leave-Behind survey normalized to a scale from 0 (lowest resilience) to 12 (highest resilience). Outcomes were survival and probability of functional independence. Survival was modeled by using Gompertz models and independence using joint survival models adjusting for sociodemographic and clinical variables. Average marginal effects were estimated to determine independence probabilities.

resultsAcross 3,409 patients aged ≥ 65 years old admitted to ICUs, preexisting frailty (30.5%) and cognitive impairment (24.3%) were common. Most patients were previously independent (82.7%). Mechanical ventilation occurred in 14.8% and sepsis in 43.2%. Those in the highest resilience group (vs lowest resilience) had a lower risk of post-ICU mortality (adjusted hazard ratio, 0.81; 95% CI, 0.70-0.94). Higher resilience was associated with greater likelihood of post-ICU functional independence (estimated probability of functional independence 5 years after ICU discharge in highest-to-lowest resilience groups (adjusted hazard ratio [95% CI]): 0.53 (0.33-0.74), 0.47 (0.26-0.68), 0.49 (0.28-0.70), and 0.36 (0.17-0.55); P < .01. Resilience was not associated with a difference in the drop in independence during the ICU stay or a difference in the pre-ICU vs post-ICU trend in predicted independence .

interpretationICU survivors with higher resilience had increased rates of survival and functional independence, although the slope of functional decline before vs after the ICU stay did not differ according to resilience group.

Indexed as

Critical IllnessIntensive Care UnitsResilience, PsychologicalActivities of Daily LivingAgedAged, 80 and overFemaleFunctional StatusHumansMaleRetrospective StudiesSurvival RateUnited Statescritical carecritical illnessICUrecovery of functionresilience

Identifiers

PMID38871280
PMCPMC13639497

What OpenQuestion holds

Textmetadata
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.