Frailty can predict the outcome of weaning from mechanical ventilation

Context
Frailty is a syndrome characterized by the loss of physical and cognitive reserve causing many complications. The frail critically ill patients are vulnerable to worse clinical outcomes especially those on mechanical ventilation. Few studies have focused on the outcome of mechanical ventilation and frailty.


Aims
To determine the effect of frailty by the clinical frailty scale (CFS) on weaning outcome in mechanically ventilated patients and its effect on hospital stay and mortality.


Settings and design
A descriptive cohort study was conducted.


Patients and methods
Patients 50 years old or more who were admitted to the respiratory ICU of Ain Shams University Hospitals and mechanically ventilated in 17 months duration were included, with exclusion of patients with pulmonary or extrapulmonary expected cause of poor weaning outcome. They were classified according to the CFS into frail and nonfrail and followed up along their total hospital stay.


Statistical analysis
Statistical Package for Social Sciences program software, version 18.0, was used for statistical analysis.


Results
A total of 55 patients were recruited, where 61.8% of them were frail by CFS. Mechanically ventilated frail patients had significantly longer mechanical ventilation days (P=0.035), prolonged weaning time (>7 days) (P=0.006), significantly higher weaning failure (P=0.0001), and significantly longer ICU and total hospital stay (P=0.021 and 0.003, respectively) than nonfrail. Readmission rate and death rate were significantly higher in frail patients (P=0.020 and 0.007, respectively).


Conclusion
Frailty was associated with complicated weaning process, reflected on the period of ICU and total hospital stay.