Evidence map›Paper›PMID 39434029›Full record

Observational studyBMC geriatrics2024

Clinical Frailty Scale score is a predictor of short-, mid- and long-term mortality in critically ill older adults (≥ 70 years) admitted to the emergency department: an observational study.

Dariush Javadzadeh, Björn W Karlson, Joakim Alfredsson, Elin Ekerstad, Jenny Hellberg, Johan Herlitz, Niklas Ekerstad

Abstract readObservational Study
In one paragraph

Observational study in BMC geriatrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing 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

8 citing papers in PubMed.

  1. Trial
  2. Article
  3. Observational
  4. Article
  5. Observational
  6. Article
  7. Review
  8. 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

7 authors.

Dariush JavadzadehDepartment of Health, Medicine, and Caring Sciences, Unit of Health Care Analysis, Linköping University, Linköping, Sweden.
Björn W KarlsonDepartment of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, and AstraZeneca Gothenburg, GothenburgMölndal, Sweden.
Joakim AlfredssonDepartment of Health, Medicine and Caring Sciences and Department of Cardiology, Unit of Cardiovascular Sciences, Linköping University, Linköping, Sweden.
Elin EkerstadDepartment of Research and Development, NU Hospital Group, Trollhättan, Sweden.
Jenny HellbergDepartment of Cardiology, NU Hospital Group, Trollhättan, Sweden.
Johan HerlitzCenter for Prehospital Research, Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.
Niklas EkerstadDepartment of Health, Medicine, and Caring Sciences, Unit of Health Care Analysis, Linköping University, Linköping, Sweden. niklas.ekerstad@liu.se.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe estimated prognos of a patient might influence the expected benefit/risk ratio of different interventions. The main purpose of this study was to investigate the Clinical Frailty Scale (CFS) score as an independent predictor of short-, mid- and long-term mortality in critically ill older adults (aged ≥ 70) admitted to the emergency department (ED).

methodsThis is a retrospective, single-center, observational study, involving critically ill older adults, recruited consecutively in an ED. All patients were followed for 6.5-7.5 years. The effect of CFS score on mortality was adjusted for the following confounders: age, sex, Charlson's Comorbidity Index, individual comorbidities and vital parameters. All patients (n = 402) were included in the short- and mid-term analyses, while patients discharged alive (n = 302) were included in the long-term analysis. Short-term mortality was analysed with logistic regression, mid- and long-term mortality with log rank test and Cox proportional hazard models. The CFS was treated as a continuous variable in the primary analyses, and as a categorical variable in completing analyses.

resultsThere was a significant association between mortality at 30 days after ED admission and CFS score, adjusted OR (95% CI) 2.07 (1.64-2.62), p < 0.0001. There was a significant association between mortality at one year after ED admission and CFS score, adjusted HR (95% CI) 1.75 (1.53-2.01), p < 0.0001. There was a significant association between mortality 6.5-7.5 years after discharge and CFS score, adjusted HR (95% CI) 1.66 (1.46-1.89), p < 0.0001. Adjusted HRs are also reported for long-term mortality, when the CFS was treated as a categorical variable: CFS-score 5 versus 1-4: HR (95% CI) 1.98 (1.27-3.08); 6 versus 1-4: HR (95% CI) 3.60 (2.39-5.44); 7 versus 1-4: HR (95% CI) 3.95 (2.38-6.55); 8-9 versus 1-4: HR (95% CI) 20.08 (9.30-43.38). The completing analyses for short- and mid-term mortality indicated a similar risk-predictive value of the CFS.

conclusionsClinical frailty scale score was independently associated with all-cause short-, mid- and long-term mortality. A nearly doubled risk of death was observed in frail patients. This information is clinically relevant, since individualised treatment and care planning for older adults should consider risk of death in different time perspectives.

Indexed as

Critical IllnessEmergency Service, HospitalFrail ElderlyFrailtyAgedAged, 80 and overFemaleFollow-Up StudiesGeriatric AssessmentHospital MortalityHumansMalePatient AdmissionPredictive Value of TestsRetrospective StudiesTime FactorsClinical frailty scaleEmergency departmentMortalityOlder adultsPredictors

Identifiers

PMID39434029
PMCPMC11492669

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.