S NAYAR 1, S Thomas 1, B Pawar 1, P GEORGE P1, S KODGIRE 1, D FERNANDES 1, G MCANULTY 2, P SECOMBE P2, P STEWART 2, C SAJIV1
1Department of Renal Medicine, Alice Springs Hospital, Alice Springs, Australia, 2Department of Intensive Care Unit, Alice Springs Hospital, Alice Springs, Australia
Aim: To estimate the effect of frailty using the Clinical Frailty scale (CFS) and Charlson Comorbidity index (CCI) on 12 month mortality in haemodialysis patients admitted to the Intensive Care Unit (ICU).
Background: Previous studies have reported higher mortality in dialysis patients requiring ICU care. The CFS has been previously validated and higher severity of frailty defined by CFS has shown to be associated with increased mortality in a retrospective Canadian haemodialysis study.
Methods: This single centre prospective study was performed on haemodialysis patients admitted to the ICU from 1/1/2018 till 30/12/2018. Comorbidity and frailty were assessed using the CCI and CFS, respectively. Patients above the age of 18 years were included. The primary end point was mortality at 12 months. Demographics, comorbid conditions, and time on dialysis was also analysed. Frailty was treated as a continuous variable. Mann- Whitney statistical analysis was conducted.
Results: 80 patients were recruited. All patients identified as Aboriginal. The mean age was 52.15 yrs. 57.5% were female. The mean duration on dialysis was 7.25 yrs. The mean CCI at baseline was 5.8. The mean ICU and hospital stay was 2.8 days and 5.6 days respectively. There was no association of frailty with mortality (p 0.16). Frailty was however associated with increasing age, duration on dialysis, CCI, ICU re-admissions and length of hospital stay. Mortality was not associated with sex, duration on dialysis, and length of hospital stay but was associated with age, higher CCI scores and hospital re-admissions.
Conclusion: In this prospective study, frailty was not associated with mortality in the 12 months following ICU admission.
Dr. Sajith Nayar is a renal physician at Alice Springs Hospital. Obtained Fellowship from Royal Australasian College of Physicians in Australia and Royal College of Physicians in UK. He has been engaged in Aboriginal Health care and research for last 6 years in Northern territory. He has been involved in collaborative general nephrology service, renal replacement therapy and renal transplantation care from both local and remote communities. Department being one of the largest interventional nephrology centre, he has gained knowledge and skills in the field of interventional nephrology for the endovascular management of dysfunctional vascular access in remote Central Australia.