PP148 - PREDICTORS OF 30-DAY MORTALITY IN INTENSIVE CARE UNIT (ICU) PATIENTS (≥65 YEARS): THE ROLE OF FRAILTY AND MALNUTRITION
PP148
PREDICTORS OF 30-DAY MORTALITY IN INTENSIVE CARE UNIT (ICU) PATIENTS (≥65 YEARS): THE ROLE OF FRAILTY AND MALNUTRITION
C. Peter1,*, E. Dresen 2, S. Röchter 1
1Department of Health and Social Sciences , Hochschule Fresenius University of Applied Sciences , Cologne , 2Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Würzburg, Würzburg , Germany
Rationale: Frailty and malnutrition represent prevalent vulnerability factors in older ICU patients and may significantly impact prognosis. Reported prevalence ranges from 21–54% for frailty and 18–60% for malnutrition or high nutritional risk, depending on the assessment method applied.
This systematic review aimed to evaluate their association with 30-day mortality in ICU patients aged ≥65 years.
Methods: A systematic literature search was conducted in PubMed, Embase and CINAHL following PRISMA guidelines. Prospective and retrospective observational studies investigating frailty and/or malnutrition in ICU patients ≥65 years with reported 30-day mortality were included. Methodological quality was assessed using the Newcastle–Ottawa Scale.
Results: Eight observational studies were included (n=5 frailty, n=2 malnutrition, n=1 both). Frailty, predominantly defined as a Clinical Frailty Scale (CFS) score ≥5 versus 1–3, was independently associated with increased 30-day mortality across studies (adjusted Hazard Ratio [aHR] 1.54 [95% CI 1.38–1.73], p<0.001; aHR 1.10 per CFS point [1.05–1.15], p<0.001; aHR 2.41 [1.77–3.27], p<0.001). A graded relationship was observed, with mortality rates up to 59% in frail subgroups compared to 32–41% in overall cohorts.
Malnutrition or high nutritional risk, defined as nutritional risk versus no nutritional risk according to study-specific screening instruments, was likewise associated with higher 30-day mortality (adjusted Odds Ratio [aOR] 3.5 [1.22–10.03], p<0.05), particularly in studies incorporating inflammatory or metabolic parameters.
Conclusion: Frailty and malnutrition are relevant predictors of 30-day mortality in ICU patients ≥65 years, with frailty emerging as a particularly robust and dose-dependent prognostic marker. Systematic assessment of vulnerability factors at ICU admission may improve risk stratification in geriatric critical care.
Disclosure of Interest: None declared