ISAR Score (Identification of Seniors At Risk) predice la mortalidad en mayores de 75 años ingresados en Cuidados Intensivos |
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Authors: | Sonia Lopez Cuenca Lorena Oteiza Noelia Lazaro Martín Mercedes Ibarz Marian Irazabal Antonio Artigas José A Lorente |
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Institution: | 1. Servicio de Medicina Intensiva y Grandes Quemados, Hospital Universitario de Getafe, Getafe, Madrid, España;2. Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, España;3. Servicio de Medicina Intensiva, Hospital Universitario Sagrat Cor, Barcelona, España;4. Servicio de Medicina Intensiva, Hospital Universitario General de Cataluña, Barcelona, España;5. Corporación Universitaria Parc Taulí, CIBER de Enfermedades Respiratorias, Universidad Autónoma de Barcelona, Sabadell, Barcelona, España;6. Departamento de Medicina Intensiva, Hospitales Universitarios Sagrado Corazón, General de Cataluña, Quirón Salud, Barcelona-San Cugat del Vallès, España;7. CIBER de Enfermedades Respiratorias, Madrid, Universidad Europea, Madrid, España |
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Abstract: | Background and objectivesCurrently, the patient's baseline situation is a more important prognostic factor than age. The purpose of this study is to estimate the prognostic value of the ISAR score (Identification of Senior at Risk) in patients ≥75 years admitted to intensive care (ICU).Patients and methodsProspective multicenter study including patients ≥75 years admitted to the ICU > 24 hours. On admission, 28 days and 6 months after discharge from the ICU, mortality and baseline were evaluated using the ISAR score, the Lawton and Brody scale (LB) and the Barthel index (BI), the Frail fragility scale. scale (FS), the Charlson comorbidity index (ICC), Dementia rating score (DRC).Results38 of 94 patients (40%) were high risk (ISAR ≥ 3) and were characterized by BI 90 (65-100), LB 4 (3-5), and CDR 1 (0-2), ICC 7.5 (6-10). 58% had FS ≥ 3. In the long term, they were in a situation of dependency BI 50 (2.5-77.5), LB 3 (0-4), CDR 1 (0-1.5)]. The ICU mortality at 28 days and 6 months was 18.4%, 25.7% and 35.3%, respectively, being statistically significant. The area under the ISAR score ROC curve was 0.749 to 0.797, in all the mortality periods studied, although the difference with other predictive variables was not significant, but the p value was the lowest.ConclusionsThe ISAR score predicts mortality in critically elderly patients with a discriminative capacity comparable to other predictive variables. |
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Keywords: | Frailty Elderly ISAR score Intensive care Baseline |
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