Autor: Fuest, Kristina - Prolib Integro

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Tytuł:: Health-related quality of life in older patients surviving ICU treatment for COVID-19 : results from an international observational study of patients older than 70 years
Autorzy:: Wernly, Bernhard
de Lange, Dylan W.
Flaatten, Hans
Moreno, Rui
Guidet, Bertrand
Artigas, Antonio
Wollborn, Jakob
Szczeklik, Wojciech
Andersen, Finn H.
Leaver, Susannah
Zafeiridis, Tilemachos
Fjolner, Jesper
Bruno, Raphael R.
Joannidis, Michael
Marsh, Brian
Oeyen, Sandra
Schefold, Joerg C.
Beil, Michael
Sviri, Sigal
van Heerden, Peter Vernon
Bollen Pinto, Bernardo
Soliman, Ivo W.
Fuest, Kristina
Jung, Christian
Banzo, Maria Jose Arche
Boumendil, Ariane
Elhadi, Muhammed
Opis:: Background: health-related quality of life (HRQoL) is an important patient-centred outcome in patients surviving ICU admission for COVID-19. It is currently not clear which domains of the HRQoL are most affected. Objective: to quantify HRQoL in order to identify areas of interventions. Design: prospective observation study. Setting: admissions to European ICUs between March 2020 and February 2021. Subjects: patients aged 70 years or older admitted with COVID-19 disease.Methods: collected determinants include SOFA-score, Clinical Frailty Scale (CFS), number and timing of ICU procedures and limitation of care, Katz Activities of Daily Living (ADL) dependence score. HRQoL was assessed at 3 months after ICU admission with the Euro-QoL-5D-5L questionnaire. An outcome of ≥4 on any of Euro-QoL-5D-5L domains was considered unfavourable. Results: in total 3,140 patients from 14 European countries were included in this study. Three months after inclusion, 1,224 patients (39.0%) were alive and the EQ-5D-5L from was obtained. The CFS was associated with an increased odds ratio for an unfavourable HRQoL outcome after 3 months; OR 1.15 (95% confidence interval (CI): 0.71–1.87) for CFS 2 to OR 4.33 (95% CI: 1.57–11.9) for CFS ≧ 7. The Katz ADL was not statistically significantly associated with HRQoL after 3 months. Conclusions: in critically ill old intensive care patients suffering from COVID-19, the CFS is associated with the subjectively perceived quality of life. The CFS on admission can be used to inform patients and relatives on the risk of an unfavourable qualitative outcome if such patients survive.
Dostawca treści:: Repozytorium Uniwersytetu Jagiellońskiego

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Tytuł:: Lactate is associated with mortality in very old intensive care patients suffering from COVID-19 : results from an international observational study of 2860 patients
Autorzy:: Baldia, Philipp Heinrich
Leaver, Susannah
Fjolner, Jesper
Jung, Christian
Artigas, Antonio
van Heerden, Peter Vernon
Arche Banzo, Maria José
Schefold, Joerg C.
Sigal, Sivri
Kelm, Malte
Flaatten, Hans
Binnebossel, Stephan
Bollen Pinto, Bernardo
Joannidis, Michael
Marsh, Brian
Beil, Michael
Zafeiridis, Tilemachos
Wernly, Bernhard
Oeyen, Sandra
Elhadi, Muhammed
De Lange, Dylan W.
Bruno, Raphael Romano
Guidet, Bertrand
Boumendil, Ariane
Andersen, Finn H.
Moreno, Rui
Szczeklik, Wojciech
Fuest, Kristina
Wollborn, Jakob
Opis:: Purpose: Lactate is an established prognosticator in critical care. However, there still is insufficient evidence about its role in predicting outcome in COVID-19. This is of particular concern in older patients who have been mostly affected during the initial surge in 2020. Methods: This prospective international observation study (The COVIP study) recruited patients aged 70 years or older (ClinicalTrials.gov ID: NCT04321265) admitted to an intensive care unit (ICU) with COVID-19 disease from March 2020 to February 2021. In addition to serial lactate values (arterial blood gas analysis), we recorded several parameters, including SOFA score, ICU procedures, limitation of care, ICU- and 3-month mortality. A lactate concentration ≥ 2.0 mmol/L on the day of ICU admission (baseline) was defined as abnormal. The primary outcome was ICU-mortality. The secondary outcomes 30-day and 3-month mortality. Results: In total, data from 2860 patients were analyzed. In most patients (68%), serum lactate was lower than 2 mmol/L. Elevated baseline serum lactate was associated with significantly higher ICU- and 3-month mortality (53% vs. 43%, and 71% vs. 57%, respectively, p < 0.001). In the multivariable analysis, the maximum lactate concentration on day 1 was independently associated with ICU mortality (aOR 1.06 95% CI 1.02–1.11; p = 0.007), 30-day mortality (aOR 1.07 95% CI 1.02–1.13; p = 0.005) and 3-month mortality (aOR 1.15 95% CI 1.08–1.24; p < 0.001) after adjustment for age, gender, SOFA score, and frailty. In 826 patients with baseline lactate ≥ 2 mmol/L sufficient data to calculate the difference between maximal levels on days 1 and 2 (∆ serum lactate) were available. A decreasing lactate concentration over time was inversely associated with ICU mortality after multivariate adjustment for SOFA score, age, Clinical Frailty Scale, and gender (aOR 0.60 95% CI 0.42–0.85; p = 0.004). Conclusion: In critically ill old intensive care patients suffering from COVID-19, lactate and its kinetics are valuable tools for outcome prediction.
Dostawca treści:: Repozytorium Uniwersytetu Jagiellońskiego

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