The association of a frailty index derived from laboratory tests and vital signs with clinical outcomes in critical care patients with septic shock: a retrospective study based on the MIMIC-IV database

• Published in: BMC infectious diseases Vol. 24; no. 1; p. 573
• Main Authors: Ding, Huafeng, Li, Xiangquan, Zhang, Xianjiang, Li, Jiaqiong, Li, Qinfeng
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 10.06.2024; BioMed Central; BMC
• Subjects: Aged; Aged, 80 and over; Blood pressure; Care and treatment; Chronic obstructive pulmonary disease; Clinical outcomes; Continuity (mathematics); Critical Care; Critical care medicine; Databases, Factual; Dehydrogenases; Diagnosis; Female; Frail elderly; Frailty; Frailty - mortality; Frailty index; Gender; Hospital Mortality; Hospital patients; Hospitals; Humans; Hypertension; Infection; Intensive care; Intensive care unit; Intensive Care Units - statistics & numerical data; Kidney diseases; Laboratories; Laboratory tests; Length of stay; Male; Medical prognosis; Methods; Middle Aged; Mortality; Patient outcomes; Patients; Phosphatase; Physiology; Rank tests; Rankings; Regression analysis; Retrospective Studies; Risk factors; Sepsis; Septic shock; Shock, Septic - mortality; Subgroups; Survival; Variables; Ventilators; Vital Signs; China; United States > US; Massachusetts; Frailty; Sepsis; Frailty index; Mortality; Intensive care unit
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-024-09430-w

Frailty is a vulnerable state to stressors due to the loss of physiological reserve as a result of multisystem dysfunction. The physiological and laboratory-based frailty index (FI-Lab), depending on laboratory values and vital signs, is a powerful tool to capture frailty status. The aim of this study was to assess the relationship between FI-Lab and in-hospital mortality in patients with septic shock. Baseline data for patients with sepsis in the intensive care unit were retrieved from the Critical Care Medicine Database (MIMIC-IV, v2.2). The primary outcome was mortality during hospitalization. The propensity score matching (PSM) method was used to analyze the basic conditions during hospitalization between groups.The FI-Lab was analysed for its relationship with in-hospital mortality using logistic regression according to continuous and categorical variables, respectively, and described using the restricted cubic spline (RCS). Survival was compared between groups using Kaplan-Meier (KM) curves. Subgroup analyses were used to improve the stability of the results. A total of 9219 patients were included. A cohort score of 1803 matched patients was generated after PSM. The analyses showed that non-surviving patients with septic shock in the ICU had a high FI-Lab index (P<0.001). FI-Lab, whether used as a continuous or categorical variable, increased with increasing FI-Lab and increased in-hospital mortality (P<0.001).Subgroup analyses showed similar results. RCS depicts this non-linear relationship. KM analysis shows the cumulative survival time during hospitalisation was significantly lower as FI-Lab increased (log-rank test, P<0.001). Elevated FI-Lab is associated with increased in-hospital mortality in patients with septic shock.