Prognostic Association Between Frailty and Post-Arrest Health Outcomes in Patients Receiving Home Care : A Population-Based Retrospective Cohort Study
Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved..
AIM: To evaluate the association between frailty and post-cardiac arrest survival, functional decline, and cognitive decline, among patients receiving home care.
METHODS: Frailty was measured using the Clinical Frailty Scale (CFS) and a valid frailty index. We used multivariable logistic regression to measure the association between frailty and post-arrest outcomes after adjusting for age, sex, and arrest setting. Functional independence and cognitive performance were measured using the interRAI ADL Long-Form and Cognitive Performance Scale, respectively. We conducted sub-group analytics of in-hospital and out-of-hospital arrests.
RESULTS: Our cohort consisted of 7,901 home care clients; most patients arrested out-of-hospital (55.4%) and were 75 years or older (66.3%). Most were classified as frail (94.2%) with a CFS score of 5 or greater. The 30-day survival rate was higher for in-hospital (26.6%) than out-of-hospital cardiac arrests (5.2%). Most patients who survived to discharge had declines in post-arrest functional independence (65.8%) and cognitive performance (46.5%). A one-point increase in the CFS decreased the odds of 30-day survival by 8% (aOR = 0.92; 95%CI = 0.87-0.97). A 0.1 unit increase in the frailty index reduced the odds of 30-day survival by 9% (aOR = 0.91; 95%CI = 0.86-0.96). The frailty index was associated with declines in functional independence (OR = 1.16; 95%CI = 1.02-1.31) and cognitive performance (OR = 1.24; 95%CI = 1.09-1.42), while the CFS was not.
CONCLUSION: Frailty is associated with cardiac arrest survival and post-arrest cognitive and functional status in patients receiving home care. Post-cardiac arrest cognitive and functional status are best predicted using more comprehensive frailty indices.
| Errataetall: |
CommentIn: Resuscitation. 2023 Jun;187:109793. - PMID 37044355 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:187 |
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| Enthalten in: |
Resuscitation - 187(2023) vom: 01. Juni, Seite 109766 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Mowbray, Fabrice I [VerfasserIn] |
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| Links: |
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| Themen: |
Advance care planning |
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| Anmerkungen: |
Date Completed 22.05.2023 Date Revised 07.06.2023 published: Print-Electronic CommentIn: Resuscitation. 2023 Jun;187:109793. - PMID 37044355 Citation Status MEDLINE |
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| doi: |
10.1016/j.resuscitation.2023.109766 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 100 | 1 | |a Mowbray, Fabrice I |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Prognostic Association Between Frailty and Post-Arrest Health Outcomes in Patients Receiving Home Care |b A Population-Based Retrospective Cohort Study |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 22.05.2023 | ||
| 500 | |a Date Revised 07.06.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: Resuscitation. 2023 Jun;187:109793. - PMID 37044355 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved. | ||
| 520 | |a AIM: To evaluate the association between frailty and post-cardiac arrest survival, functional decline, and cognitive decline, among patients receiving home care | ||
| 520 | |a METHODS: Frailty was measured using the Clinical Frailty Scale (CFS) and a valid frailty index. We used multivariable logistic regression to measure the association between frailty and post-arrest outcomes after adjusting for age, sex, and arrest setting. Functional independence and cognitive performance were measured using the interRAI ADL Long-Form and Cognitive Performance Scale, respectively. We conducted sub-group analytics of in-hospital and out-of-hospital arrests | ||
| 520 | |a RESULTS: Our cohort consisted of 7,901 home care clients; most patients arrested out-of-hospital (55.4%) and were 75 years or older (66.3%). Most were classified as frail (94.2%) with a CFS score of 5 or greater. The 30-day survival rate was higher for in-hospital (26.6%) than out-of-hospital cardiac arrests (5.2%). Most patients who survived to discharge had declines in post-arrest functional independence (65.8%) and cognitive performance (46.5%). A one-point increase in the CFS decreased the odds of 30-day survival by 8% (aOR = 0.92; 95%CI = 0.87-0.97). A 0.1 unit increase in the frailty index reduced the odds of 30-day survival by 9% (aOR = 0.91; 95%CI = 0.86-0.96). The frailty index was associated with declines in functional independence (OR = 1.16; 95%CI = 1.02-1.31) and cognitive performance (OR = 1.24; 95%CI = 1.09-1.42), while the CFS was not | ||
| 520 | |a CONCLUSION: Frailty is associated with cardiac arrest survival and post-arrest cognitive and functional status in patients receiving home care. Post-cardiac arrest cognitive and functional status are best predicted using more comprehensive frailty indices | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Advance care planning | |
| 650 | 4 | |a Cardiac arrest | |
| 650 | 4 | |a Frailty | |
| 650 | 4 | |a Home care | |
| 700 | 1 | |a Turcotte, Luke |e verfasserin |4 aut | |
| 700 | 1 | |a Strum, Ryan P |e verfasserin |4 aut | |
| 700 | 1 | |a de Wit, Kerstin |e verfasserin |4 aut | |
| 700 | 1 | |a Griffith, Lauren E |e verfasserin |4 aut | |
| 700 | 1 | |a Worster, Andrew |e verfasserin |4 aut | |
| 700 | 1 | |a Foroutan, Farid |e verfasserin |4 aut | |
| 700 | 1 | |a Heckman, George |e verfasserin |4 aut | |
| 700 | 1 | |a Hebert, Paul |e verfasserin |4 aut | |
| 700 | 1 | |a Schumacher, Connie |e verfasserin |4 aut | |
| 700 | 1 | |a Jones, Aaron |e verfasserin |4 aut | |
| 700 | 1 | |a Mercier, Eric |e verfasserin |4 aut | |
| 700 | 1 | |a Gayowsky, Anastasia |e verfasserin |4 aut | |
| 700 | 1 | |a Costa, Andrew P |e verfasserin |4 aut | |
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