Baldwin et al identified subtypes of frailty following acute respiratory failure and ICU care. The authors are from Columbia University, University of Washington, and Johns Hopkins University.
Patient selection: age >= 65 years and survival of acute respiratory failure
Parameters:
(1) clinical gestalt
(2) prehospital ADL disability
(3) prehospital frailty
(4) post-ICU cognitive impairment
(5) post-ICU frailty
(6) discharge to skilled nursing facility
Subtype
Clinical
Prehospital Disability
Prehospital Frailty
1
robust
0%
0%
2
recoverably frail
0%
44%
3
acutely frail
26%
4
chronically frail
65%
5
end-stage frail
> 90%
Subtype
Cognitive Impairment
Post-ICU Frailty
Skilled Nursing Facility
1
9.5%
0%
9.5%
2
13%
57%
20%
3
31%
63%
4
0%
93%
63.2%
5
100%
> 90%
64.9%
Subtype 2 showed good recovery in ADL at 6 months.
Serum Interleukin-6 concentrations were higher in subtypes 3 to 5.
Subtype
6-Month Mortality
1
0%
2
7%
3
18%
4
16%
5
33%
One possible way of looking at this data:
Subtype
Prehospital Disability
Post-ICU Frailty
Recovery at 6 Months
1
no
no
yes
2
no
yes
yes
3
no
yes
no
4
yes
yes
no
5
yes
yes
no
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