Impact of frailty on protocol‐based weaning from mechanical ventilation in patients with sepsis: a retrospective cohort study
Frailty was associated with delayed extubation on protocol‐based weaning from mechanical ventilation. Aim Frailty has been shown to be associated with prolonged mechanical ventilation (MV). However, due to limited physiological data, it has been unclear how frailty affects weaning from MV in septic...
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| Veröffentlicht in: | Acute medicine & surgery 2020-01, Vol.7 (1), p.e608-n/a |
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| creator | Matsuda, Wataru Uemura, Tatsuki Yamamoto, Makiko Uemura, Yukari Kimura, Akio |
| description | Frailty was associated with delayed extubation on protocol‐based weaning from mechanical ventilation.
Aim
Frailty has been shown to be associated with prolonged mechanical ventilation (MV). However, due to limited physiological data, it has been unclear how frailty affects weaning from MV in septic patients subjected to a specific weaning protocol.
Methods
This was a single‐center retrospective cohort study. The study included patients with sepsis on MV who underwent protocol‐based weaning between August 2015 and December 2018. Frailty was defined as a Clinical Frailty Scale score 4 or more. The association between frailty and weaning was evaluated.
Results
Ninety‐nine eligible patients were identified and categorized as frail (n = 67) or not frail (n = 32). The duration of MV was significantly longer in the frail group (8 days versus 5 days, P |
| doi_str_mv | 10.1002/ams2.608 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7705235</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2469071183</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3928-697c2656184319943715137fff3f8cb5a52771f866a43bcc542762e9aa21f00a3</originalsourceid><addsrcrecordid>eNp1kc9qFTEUxoMotrQFn0ACbtxMzZ-ZZOJCKMVqocWFug7n5ia9KZnJmGTu5a7sI_QZ-yTm0lqr4ConJ7_z8eV8CL2i5JgSwt7BkNmxIP0ztM9Ix5q-p_L5k3oPHeV8TQihlHAh6Eu0xzlTqhNiH_08HyYwBUeHXQIfyhbHEU8plmhiuLu5XUC2S7yxMPrxqjJxwIM1q3o1EPDajsUHKL4O-TpXq9rJeOPLCmc7ZZ_fY8DJlhTzZE3xa4tNXMVUcC7zcnuIXjgI2R49nAfo-9nHb6efm4svn85PTy4awxXrG6GkYaITtG85VarlknaUS-ccd71ZdNAxKanrhYCWL4zpWiYFswqAUUcI8AP04V53mheDXZrqMkHQU_IDpK2O4PXfL6Nf6au41lLWPfKuCrx9EEjxx2xz0YPPxoYAo41z1qwVikhKe17RN_-g13FOY_1epWTLWyWU-CNo6mpysu7RDCV6F6zeBatrsBV9_dT8I_g7xgo098DGB7v9r5A-ufzKdoK_AGWlrys</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2474349696</pqid></control><display><type>article</type><title>Impact of frailty on protocol‐based weaning from mechanical ventilation in patients with sepsis: a retrospective cohort study</title><source>DOAJ Directory of Open Access Journals</source><source>Access via Wiley Online Library</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Wiley Online Library (Open Access Collection)</source><source>PubMed Central</source><creator>Matsuda, Wataru ; Uemura, Tatsuki ; Yamamoto, Makiko ; Uemura, Yukari ; Kimura, Akio</creator><creatorcontrib>Matsuda, Wataru ; Uemura, Tatsuki ; Yamamoto, Makiko ; Uemura, Yukari ; Kimura, Akio</creatorcontrib><description>Frailty was associated with delayed extubation on protocol‐based weaning from mechanical ventilation.
Aim
Frailty has been shown to be associated with prolonged mechanical ventilation (MV). However, due to limited physiological data, it has been unclear how frailty affects weaning from MV in septic patients subjected to a specific weaning protocol.
Methods
This was a single‐center retrospective cohort study. The study included patients with sepsis on MV who underwent protocol‐based weaning between August 2015 and December 2018. Frailty was defined as a Clinical Frailty Scale score 4 or more. The association between frailty and weaning was evaluated.
Results
Ninety‐nine eligible patients were identified and categorized as frail (n = 67) or not frail (n = 32). The duration of MV was significantly longer in the frail group (8 days versus 5 days, P < 0.01). In multivariate analysis, frailty was independently associated with duration of MV (regression coefficient 17.97, 95% confidence interval 1.77–34.17) and successful weaning (hazard ratio 0.60, 95% confidence interval 0.36–1.00). There was no significant between‐group difference in duration until the first separation attempt or reintubation rate. Respiratory failure was significantly more common in the frail group as a cause of weaning failure, whereas airway failure was common in both groups.
Conclusion
Frailty was independently associated with a longer duration of MV in patients with sepsis who underwent protocol‐based weaning. Frail patients were more likely to fail spontaneous breathing trials than nonfrail patients during the weaning process, although the risk after extubation was similar.</description><identifier>ISSN: 2052-8817</identifier><identifier>EISSN: 2052-8817</identifier><identifier>DOI: 10.1002/ams2.608</identifier><identifier>PMID: 33299566</identifier><language>eng</language><publisher>United States: John Wiley & Sons, Inc</publisher><subject>Age ; Aged ; airway extubation ; Body mass index ; Chronic fatigue syndrome ; Cohort analysis ; Disease ; Frailty ; Infections ; Intensive care ; intensive care units ; Mortality ; Original ; Ostomy ; Patients ; respiratory insufficiency ; Sepsis ; Tracheotomy ; ventilator weaning ; Ventilators ; Weaning</subject><ispartof>Acute medicine & surgery, 2020-01, Vol.7 (1), p.e608-n/a</ispartof><rights>2020 The Authors. published by John Wiley & Sons Australia, Ltd on behalf of Japanese Association for Acute Medicine</rights><rights>2020 The Authors. Acute Medicine & Surgery published by John Wiley & Sons Australia, Ltd on behalf of Japanese Association for Acute Medicine.</rights><rights>2020. This work is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3928-697c2656184319943715137fff3f8cb5a52771f866a43bcc542762e9aa21f00a3</citedby><cites>FETCH-LOGICAL-c3928-697c2656184319943715137fff3f8cb5a52771f866a43bcc542762e9aa21f00a3</cites><orcidid>0000-0002-1807-6893 ; 0000-0001-9288-0663</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7705235/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7705235/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,865,886,1418,11567,27929,27930,45579,45580,46057,46481,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33299566$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Matsuda, Wataru</creatorcontrib><creatorcontrib>Uemura, Tatsuki</creatorcontrib><creatorcontrib>Yamamoto, Makiko</creatorcontrib><creatorcontrib>Uemura, Yukari</creatorcontrib><creatorcontrib>Kimura, Akio</creatorcontrib><title>Impact of frailty on protocol‐based weaning from mechanical ventilation in patients with sepsis: a retrospective cohort study</title><title>Acute medicine & surgery</title><addtitle>Acute Med Surg</addtitle><description>Frailty was associated with delayed extubation on protocol‐based weaning from mechanical ventilation.
Aim
Frailty has been shown to be associated with prolonged mechanical ventilation (MV). However, due to limited physiological data, it has been unclear how frailty affects weaning from MV in septic patients subjected to a specific weaning protocol.
Methods
This was a single‐center retrospective cohort study. The study included patients with sepsis on MV who underwent protocol‐based weaning between August 2015 and December 2018. Frailty was defined as a Clinical Frailty Scale score 4 or more. The association between frailty and weaning was evaluated.
Results
Ninety‐nine eligible patients were identified and categorized as frail (n = 67) or not frail (n = 32). The duration of MV was significantly longer in the frail group (8 days versus 5 days, P < 0.01). In multivariate analysis, frailty was independently associated with duration of MV (regression coefficient 17.97, 95% confidence interval 1.77–34.17) and successful weaning (hazard ratio 0.60, 95% confidence interval 0.36–1.00). There was no significant between‐group difference in duration until the first separation attempt or reintubation rate. Respiratory failure was significantly more common in the frail group as a cause of weaning failure, whereas airway failure was common in both groups.
Conclusion
Frailty was independently associated with a longer duration of MV in patients with sepsis who underwent protocol‐based weaning. Frail patients were more likely to fail spontaneous breathing trials than nonfrail patients during the weaning process, although the risk after extubation was similar.</description><subject>Age</subject><subject>Aged</subject><subject>airway extubation</subject><subject>Body mass index</subject><subject>Chronic fatigue syndrome</subject><subject>Cohort analysis</subject><subject>Disease</subject><subject>Frailty</subject><subject>Infections</subject><subject>Intensive care</subject><subject>intensive care units</subject><subject>Mortality</subject><subject>Original</subject><subject>Ostomy</subject><subject>Patients</subject><subject>respiratory insufficiency</subject><subject>Sepsis</subject><subject>Tracheotomy</subject><subject>ventilator weaning</subject><subject>Ventilators</subject><subject>Weaning</subject><issn>2052-8817</issn><issn>2052-8817</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNp1kc9qFTEUxoMotrQFn0ACbtxMzZ-ZZOJCKMVqocWFug7n5ia9KZnJmGTu5a7sI_QZ-yTm0lqr4ConJ7_z8eV8CL2i5JgSwt7BkNmxIP0ztM9Ix5q-p_L5k3oPHeV8TQihlHAh6Eu0xzlTqhNiH_08HyYwBUeHXQIfyhbHEU8plmhiuLu5XUC2S7yxMPrxqjJxwIM1q3o1EPDajsUHKL4O-TpXq9rJeOPLCmc7ZZ_fY8DJlhTzZE3xa4tNXMVUcC7zcnuIXjgI2R49nAfo-9nHb6efm4svn85PTy4awxXrG6GkYaITtG85VarlknaUS-ccd71ZdNAxKanrhYCWL4zpWiYFswqAUUcI8AP04V53mheDXZrqMkHQU_IDpK2O4PXfL6Nf6au41lLWPfKuCrx9EEjxx2xz0YPPxoYAo41z1qwVikhKe17RN_-g13FOY_1epWTLWyWU-CNo6mpysu7RDCV6F6zeBatrsBV9_dT8I_g7xgo098DGB7v9r5A-ufzKdoK_AGWlrys</recordid><startdate>202001</startdate><enddate>202001</enddate><creator>Matsuda, Wataru</creator><creator>Uemura, Tatsuki</creator><creator>Yamamoto, Makiko</creator><creator>Uemura, Yukari</creator><creator>Kimura, Akio</creator><general>John Wiley & Sons, Inc</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>WIN</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-1807-6893</orcidid><orcidid>https://orcid.org/0000-0001-9288-0663</orcidid></search><sort><creationdate>202001</creationdate><title>Impact of frailty on protocol‐based weaning from mechanical ventilation in patients with sepsis: a retrospective cohort study</title><author>Matsuda, Wataru ; Uemura, Tatsuki ; Yamamoto, Makiko ; Uemura, Yukari ; Kimura, Akio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3928-697c2656184319943715137fff3f8cb5a52771f866a43bcc542762e9aa21f00a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Age</topic><topic>Aged</topic><topic>airway extubation</topic><topic>Body mass index</topic><topic>Chronic fatigue syndrome</topic><topic>Cohort analysis</topic><topic>Disease</topic><topic>Frailty</topic><topic>Infections</topic><topic>Intensive care</topic><topic>intensive care units</topic><topic>Mortality</topic><topic>Original</topic><topic>Ostomy</topic><topic>Patients</topic><topic>respiratory insufficiency</topic><topic>Sepsis</topic><topic>Tracheotomy</topic><topic>ventilator weaning</topic><topic>Ventilators</topic><topic>Weaning</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Matsuda, Wataru</creatorcontrib><creatorcontrib>Uemura, Tatsuki</creatorcontrib><creatorcontrib>Yamamoto, Makiko</creatorcontrib><creatorcontrib>Uemura, Yukari</creatorcontrib><creatorcontrib>Kimura, Akio</creatorcontrib><collection>Wiley Online Library (Open Access Collection)</collection><collection>Wiley Online Library (Open Access Collection)</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Acute medicine & surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Matsuda, Wataru</au><au>Uemura, Tatsuki</au><au>Yamamoto, Makiko</au><au>Uemura, Yukari</au><au>Kimura, Akio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of frailty on protocol‐based weaning from mechanical ventilation in patients with sepsis: a retrospective cohort study</atitle><jtitle>Acute medicine & surgery</jtitle><addtitle>Acute Med Surg</addtitle><date>2020-01</date><risdate>2020</risdate><volume>7</volume><issue>1</issue><spage>e608</spage><epage>n/a</epage><pages>e608-n/a</pages><issn>2052-8817</issn><eissn>2052-8817</eissn><abstract>Frailty was associated with delayed extubation on protocol‐based weaning from mechanical ventilation.
Aim
Frailty has been shown to be associated with prolonged mechanical ventilation (MV). However, due to limited physiological data, it has been unclear how frailty affects weaning from MV in septic patients subjected to a specific weaning protocol.
Methods
This was a single‐center retrospective cohort study. The study included patients with sepsis on MV who underwent protocol‐based weaning between August 2015 and December 2018. Frailty was defined as a Clinical Frailty Scale score 4 or more. The association between frailty and weaning was evaluated.
Results
Ninety‐nine eligible patients were identified and categorized as frail (n = 67) or not frail (n = 32). The duration of MV was significantly longer in the frail group (8 days versus 5 days, P < 0.01). In multivariate analysis, frailty was independently associated with duration of MV (regression coefficient 17.97, 95% confidence interval 1.77–34.17) and successful weaning (hazard ratio 0.60, 95% confidence interval 0.36–1.00). There was no significant between‐group difference in duration until the first separation attempt or reintubation rate. Respiratory failure was significantly more common in the frail group as a cause of weaning failure, whereas airway failure was common in both groups.
Conclusion
Frailty was independently associated with a longer duration of MV in patients with sepsis who underwent protocol‐based weaning. Frail patients were more likely to fail spontaneous breathing trials than nonfrail patients during the weaning process, although the risk after extubation was similar.</abstract><cop>United States</cop><pub>John Wiley & Sons, Inc</pub><pmid>33299566</pmid><doi>10.1002/ams2.608</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-1807-6893</orcidid><orcidid>https://orcid.org/0000-0001-9288-0663</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Acute medicine & surgery, 2020-01, Vol.7 (1), p.e608-n/a |
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| source | DOAJ Directory of Open Access Journals; Access via Wiley Online Library; EZB-FREE-00999 freely available EZB journals; Wiley Online Library (Open Access Collection); PubMed Central |
| subjects | Age Aged airway extubation Body mass index Chronic fatigue syndrome Cohort analysis Disease Frailty Infections Intensive care intensive care units Mortality Original Ostomy Patients respiratory insufficiency Sepsis Tracheotomy ventilator weaning Ventilators Weaning |
| title | Impact of frailty on protocol‐based weaning from mechanical ventilation in patients with sepsis: a retrospective cohort study |
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