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Functional Independence Measure score is associated with mortality in critically ill elderly patients admitted to an intermediate care unit

BACKGROUND: Age alone is not a robust predictor of mortality in critically ill elderly patients. Chronic health status and functional status before admission could be better predictors. This study aimed to determine whether functional status, assessed using the Functional Independence Measure (FIM),...

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Autores principales: D’Andrea, A., Le Peillet, D., Fassier, T., Prendki, V., Trombert, V., Reny, J-L, Roux, X.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7488031/
https://www.ncbi.nlm.nih.gov/pubmed/32907534
http://dx.doi.org/10.1186/s12877-020-01729-y
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author D’Andrea, A.
Le Peillet, D.
Fassier, T.
Prendki, V.
Trombert, V.
Reny, J-L
Roux, X.
author_facet D’Andrea, A.
Le Peillet, D.
Fassier, T.
Prendki, V.
Trombert, V.
Reny, J-L
Roux, X.
author_sort D’Andrea, A.
collection PubMed
description BACKGROUND: Age alone is not a robust predictor of mortality in critically ill elderly patients. Chronic health status and functional status before admission could be better predictors. This study aimed to determine whether functional status, assessed using the Functional Independence Measure (FIM), could be an independent predictor of mortality in a geriatric population admitted to an intermediate care unit (IMCU). METHODS: A monocentric, retrospective, observational study of all patients aged ≥75 years old admitted to Geneva University Hospitals’ geriatric IMCU between 01.01.2012 and 31.05.2016. The study’s primary outcome metrics were one-year mortality’s associations with a pre-admission FIM score and other relevant prospectively recorded prognostic variables. RESULTS: A total of 345 patients were included (56% female, mean age 85 +/− 6.5 years). Mean FIM score was 66 +/− 26. One-year mortality was 57%. Dichotomized low (≤ 63) and high FIM (> 63) scores were associated with one-year mortalities of 68 and 44%, respectively. Logistic regression calculations found an association between pre-admission FIM score and one-year mortality (p <  0.0001), including variables usually associated with mortality (e.g., age, sex, comorbidities, mini-mental health state score, renal function). Multivariate survival analysis showed a significant difference between groups, with a hazard ratio of 0.29 (95% CI: 0.13–0.65) for patients with high FIM scores. CONCLUSIONS: In the present study, higher functional status, assessed using the FIM tool before admission to an IMCU, was significantly and independently associated with lower one-year mortality. This opens up perspectives on the potential value of FIM for establishing a finer prognosis and better triage of critically ill older patients.
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spelling pubmed-74880312020-09-16 Functional Independence Measure score is associated with mortality in critically ill elderly patients admitted to an intermediate care unit D’Andrea, A. Le Peillet, D. Fassier, T. Prendki, V. Trombert, V. Reny, J-L Roux, X. BMC Geriatr Research Article BACKGROUND: Age alone is not a robust predictor of mortality in critically ill elderly patients. Chronic health status and functional status before admission could be better predictors. This study aimed to determine whether functional status, assessed using the Functional Independence Measure (FIM), could be an independent predictor of mortality in a geriatric population admitted to an intermediate care unit (IMCU). METHODS: A monocentric, retrospective, observational study of all patients aged ≥75 years old admitted to Geneva University Hospitals’ geriatric IMCU between 01.01.2012 and 31.05.2016. The study’s primary outcome metrics were one-year mortality’s associations with a pre-admission FIM score and other relevant prospectively recorded prognostic variables. RESULTS: A total of 345 patients were included (56% female, mean age 85 +/− 6.5 years). Mean FIM score was 66 +/− 26. One-year mortality was 57%. Dichotomized low (≤ 63) and high FIM (> 63) scores were associated with one-year mortalities of 68 and 44%, respectively. Logistic regression calculations found an association between pre-admission FIM score and one-year mortality (p <  0.0001), including variables usually associated with mortality (e.g., age, sex, comorbidities, mini-mental health state score, renal function). Multivariate survival analysis showed a significant difference between groups, with a hazard ratio of 0.29 (95% CI: 0.13–0.65) for patients with high FIM scores. CONCLUSIONS: In the present study, higher functional status, assessed using the FIM tool before admission to an IMCU, was significantly and independently associated with lower one-year mortality. This opens up perspectives on the potential value of FIM for establishing a finer prognosis and better triage of critically ill older patients. BioMed Central 2020-09-09 /pmc/articles/PMC7488031/ /pubmed/32907534 http://dx.doi.org/10.1186/s12877-020-01729-y Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
D’Andrea, A.
Le Peillet, D.
Fassier, T.
Prendki, V.
Trombert, V.
Reny, J-L
Roux, X.
Functional Independence Measure score is associated with mortality in critically ill elderly patients admitted to an intermediate care unit
title Functional Independence Measure score is associated with mortality in critically ill elderly patients admitted to an intermediate care unit
title_full Functional Independence Measure score is associated with mortality in critically ill elderly patients admitted to an intermediate care unit
title_fullStr Functional Independence Measure score is associated with mortality in critically ill elderly patients admitted to an intermediate care unit
title_full_unstemmed Functional Independence Measure score is associated with mortality in critically ill elderly patients admitted to an intermediate care unit
title_short Functional Independence Measure score is associated with mortality in critically ill elderly patients admitted to an intermediate care unit
title_sort functional independence measure score is associated with mortality in critically ill elderly patients admitted to an intermediate care unit
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7488031/
https://www.ncbi.nlm.nih.gov/pubmed/32907534
http://dx.doi.org/10.1186/s12877-020-01729-y
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