Dados do Trabalho

Título

Frailty as a Predictor of Mortality and Prolonged ICU Stay in Septic Patients: The Role of the Modified Frailty Index

Objetivo

To evaluate the frailty score in septic patients admitted to an ICU and its relationship with patient outcomes.

Métodos

A cohort study involving patients admitted to the Adult ICU of a Private Hospital in João Pessoa.

Resultados

A total of 337 patients were evaluated, with a median age of 72 (54.5-83) years and an MFI score of 0.18 (0.09-0.27). Among these, 80 (23.7%) had a diagnosis of dementia. The median ICU stay was 3 (2-5) days, and ICU mortality was 8.3%. Patients with any degree of frailty had higher mortality (9.7% vs. 3.8%, p<0.001) and longer ICU stays (3 [2-5.25] vs. 2 [1-3], p<0.001). Dementia was associated with higher mortality (11.3% vs. 7.4%, p=0.059) but did not significantly affect ICU stay duration (3 [2-6] vs. 3 [2-5], p=0.479). The ROC curve area for predicting ICU mortality using the MFI was 0.755 (95% CI 0.654-0.855, p<0.001). In multivariate analysis, the odds ratio for each 0.1-point increase in the MFI score was 1.517 (95% CI 1.406-1.637, p<0.001) for mortality and 1.419 (95% CI 1.334-1.509) for prolonged ICU stay (>7 days). Dementia had an OR of 1.114 (95% CI 0.8-1.552, p=0.378) for mortality and 0.635 (95% CI 0.340-1.185, p=0.153) for prolonged ICU stay.

Conclusão

Frailty was shown to be a significant marker of severity in these patients, with each 0.1-point increase in the MFI score associated with a 51.7% increase in the risk of mortality and a 41.9% increase in the risk of prolonged ICU stay. The MFI score demonstrated acceptable discriminative power for mortality. In this elderly population, the high age range may have diminished the impact of dementia as a risk factor for mortality and prolonged ICU stay.