array:24 [
  "pii" => "S2173572719301390"
  "issn" => "21735727"
  "doi" => "10.1016/j.medine.2019.04.006"
  "estado" => "S300"
  "fechaPublicacion" => "2019-10-01"
  "aid" => "1348"
  "copyright" => "Elsevier España, S.L.U. and SEMICYUC"
  "copyrightAnyo" => "2019"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "sco"
  "cita" => "Med Intensiva. 2019;43:393-4"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 58
    "formatos" => array:3 [
      "EPUB" => 12
      "HTML" => 24
      "PDF" => 22
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0210569119301329"
      "issn" => "02105691"
      "doi" => "10.1016/j.medin.2019.04.007"
      "estado" => "S300"
      "fechaPublicacion" => "2019-10-01"
      "aid" => "1348"
      "copyright" => "Elsevier España, S.L.U. y SEMICYUC"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "sco"
      "cita" => "Med Intensiva. 2019;43:393-4"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 268
        "formatos" => array:3 [
          "EPUB" => 20
          "HTML" => 170
          "PDF" => 78
        ]
      ]
      "es" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">EDITORIAL</span>"
        "titulo" => "&#191;Resulta &#250;til evaluar la fragilidad de los pacientes al ingreso en la unidad de cuidados intensivos &#40;UCI&#41;&#63;"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "393"
            "paginaFinal" => "394"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Is it useful to assess patient frailty upon admission to the Intensive Care Unit &#40;ICU&#41;&#63;"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "O&#46; Rubio Sanchiz, R&#46; Fern&#225;ndez Fern&#225;ndez"
            "autores" => array:2 [
              0 => array:2 [
                "nombre" => "O&#46;"
                "apellidos" => "Rubio Sanchiz"
              ]
              1 => array:2 [
                "nombre" => "R&#46;"
                "apellidos" => "Fern&#225;ndez Fern&#225;ndez"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2173572719301390"
          "doi" => "10.1016/j.medine.2019.04.006"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572719301390?idApp=WMIE"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569119301329?idApp=WMIE"
      "url" => "/02105691/0000004300000007/v1_201910100635/S0210569119301329/v1_201910100635/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2173572719301407"
    "issn" => "21735727"
    "doi" => "10.1016/j.medine.2019.01.007"
    "estado" => "S300"
    "fechaPublicacion" => "2019-10-01"
    "aid" => "1315"
    "copyright" => "The Author&#40;s&#41;"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Med Intensiva. 2019;43:395-401"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 194
      "formatos" => array:3 [
        "EPUB" => 36
        "HTML" => 130
        "PDF" => 28
      ]
    ]
    "en" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
      "titulo" => "Frailty in patients over 65 years of age admitted to Intensive Care Units &#40;FRAIL-ICU&#41;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "395"
          "paginaFinal" => "401"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Fragilidad en pacientes mayores de 65 a&#241;os ingresados en cuidados intensivos &#40;FRAIL-ICU&#41;"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "S&#46; L&#243;pez Cuenca, L&#46; Oteiza L&#243;pez, N&#46; L&#225;zaro Mart&#237;n, M&#46;M&#46; Irazabal Jaimes, M&#46; Ibarz Villamayor, A&#46; Artigas, J&#46;A&#46; Lorente Balanza"
          "autores" => array:7 [
            0 => array:2 [
              "nombre" => "S&#46;"
              "apellidos" => "L&#243;pez Cuenca"
            ]
            1 => array:2 [
              "nombre" => "L&#46;"
              "apellidos" => "Oteiza L&#243;pez"
            ]
            2 => array:2 [
              "nombre" => "N&#46;"
              "apellidos" => "L&#225;zaro Mart&#237;n"
            ]
            3 => array:2 [
              "nombre" => "M&#46;M&#46;"
              "apellidos" => "Irazabal Jaimes"
            ]
            4 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Ibarz Villamayor"
            ]
            5 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Artigas"
            ]
            6 => array:2 [
              "nombre" => "J&#46;A&#46;"
              "apellidos" => "Lorente Balanza"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0210569119300415"
        "doi" => "10.1016/j.medin.2019.01.010"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569119300415?idApp=WMIE"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572719301407?idApp=WMIE"
    "url" => "/21735727/0000004300000007/v1_201910040722/S2173572719301407/v1_201910040722/en/main.assets"
  ]
  "asociados" => array:1 [
    0 => array:19 [
      "pii" => "S2173572719301407"
      "issn" => "21735727"
      "doi" => "10.1016/j.medine.2019.01.007"
      "estado" => "S300"
      "fechaPublicacion" => "2019-10-01"
      "aid" => "1315"
      "copyright" => "The Author&#40;s&#41;"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "fla"
      "cita" => "Med Intensiva. 2019;43:395-401"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 194
        "formatos" => array:3 [
          "EPUB" => 36
          "HTML" => 130
          "PDF" => 28
        ]
      ]
      "en" => array:12 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
        "titulo" => "Frailty in patients over 65 years of age admitted to Intensive Care Units &#40;FRAIL-ICU&#41;"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "tieneResumen" => array:2 [
          0 => "en"
          1 => "es"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "395"
            "paginaFinal" => "401"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "es" => array:1 [
            "titulo" => "Fragilidad en pacientes mayores de 65 a&#241;os ingresados en cuidados intensivos &#40;FRAIL-ICU&#41;"
          ]
        ]
        "contieneResumen" => array:2 [
          "en" => true
          "es" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "S&#46; L&#243;pez Cuenca, L&#46; Oteiza L&#243;pez, N&#46; L&#225;zaro Mart&#237;n, M&#46;M&#46; Irazabal Jaimes, M&#46; Ibarz Villamayor, A&#46; Artigas, J&#46;A&#46; Lorente Balanza"
            "autores" => array:7 [
              0 => array:2 [
                "nombre" => "S&#46;"
                "apellidos" => "L&#243;pez Cuenca"
              ]
              1 => array:2 [
                "nombre" => "L&#46;"
                "apellidos" => "Oteiza L&#243;pez"
              ]
              2 => array:2 [
                "nombre" => "N&#46;"
                "apellidos" => "L&#225;zaro Mart&#237;n"
              ]
              3 => array:2 [
                "nombre" => "M&#46;M&#46;"
                "apellidos" => "Irazabal Jaimes"
              ]
              4 => array:2 [
                "nombre" => "M&#46;"
                "apellidos" => "Ibarz Villamayor"
              ]
              5 => array:2 [
                "nombre" => "A&#46;"
                "apellidos" => "Artigas"
              ]
              6 => array:2 [
                "nombre" => "J&#46;A&#46;"
                "apellidos" => "Lorente Balanza"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "es" => array:9 [
          "pii" => "S0210569119300415"
          "doi" => "10.1016/j.medin.2019.01.010"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "es"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569119300415?idApp=WMIE"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572719301407?idApp=WMIE"
      "url" => "/21735727/0000004300000007/v1_201910040722/S2173572719301407/v1_201910040722/en/main.assets"
    ]
  ]
  "en" => array:12 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>"
    "titulo" => "Is it useful to assess patient frailty upon admission to the Intensive Care Unit &#40;ICU&#41;&#63;"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "393"
        "paginaFinal" => "394"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "O&#46; Rubio Sanchiz, R&#46; Fern&#225;ndez Fern&#225;ndez"
        "autores" => array:2 [
          0 => array:4 [
            "nombre" => "O&#46;"
            "apellidos" => "Rubio Sanchiz"
            "email" => array:1 [
              0 => "orubio@althaia.cat"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "R&#46;"
            "apellidos" => "Fern&#225;ndez Fern&#225;ndez"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Servicio de Medicina Intensiva&#44; Althaia Xarxa Hospitalaria Universitaria de Manresa&#44; Manresa&#44; Barcelona&#44; Spain"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "&#191;Resulta &#250;til evaluar la fragilidad de los pacientes al ingreso en la unidad de cuidados intensivos &#40;UCI&#41;&#63;"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">In this issue of <span class="elsevierStyleSmallCaps">Medicina</span><span class="elsevierStyleSmallCaps">Intensiva</span> we publish an interesting research on the prevalence of frailty in patients over 65 years old &#40;FRAIL-ICU&#41; that amounts to 35&#37;&#44;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">1</span></a> and its direct impact on mortality&#44; especially 1 month and 6 months after ICU discharge&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Probably some readers will wonder what sense does it make to measure frailty at the ICU&#44; what the profile of these patients should be&#44; and what the utility of all this may be&#63;</p><p id="par0015" class="elsevierStylePara elsevierViewall">In an era defined by the necessary efficiency of the healthcare system with more and more elderly patients being admitted to ICUs&#44; more complexity and comorbidities&#44; worse prior functional statuses and therefore&#44; frail and vulnerable&#44; the initial assessment of these patients has become more and more necessary&#46; And yet there is still uncertainty about the mortality results and quality of life of this subgroup of patients&#44; which is why we need objective predictive tools to help us decide what patients will benefit the most from the ICU stay&#44; and who won&#8217;t&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">2</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Are the traditional criteria based on the patient&#39;s age&#44; will&#44; severity&#44; prognosis&#44; quality of life&#44; presence of comorbidity&#44; etc&#46; any good anymore&#63;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Are we convinced about not making positive discrimination by admitting patients without a clear benefit&#8230; or negative discrimination by denying admission to patients just because they are too old&#63;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The severity of the disease that conditions the ICU admission and the patient&#39;s prior functional status&#44; rather than age itself&#44; are the key elements that determine the patient&#39;s overall mortality&#44; and long-term vital prognosis and functional status&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">3</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The traditional criteria used in younger patients&#44; with fewer comorbidities and diseases of one system only and acute decompensations cannot be used with complex patients or patients with several diseases or frail patients&#44; so new tools are needed and they need to be more adapted to the most prevalent type of patient with more multidimensional and holistic assessments of such patients&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">4</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">On the other hand&#44; it would be interesting to know what health results are patients really expecting&#44; above all complex patients and patients with multiple diseases&#44; but&#8230; what results do patients care the most&#63; Saving their lives at all cost is a good health outcome for them&#63; Or maybe recovering an acceptable functionality and quality of life after the ICU admission would be a better outcome&#63;</p><p id="par0045" class="elsevierStylePara elsevierViewall">It is hard to know or predict what is best for this or that patient&#44; and here the first step should always be knowing the patient&#39;s will after giving him honest information of what is at stake during an ICU admission&#46; Patients admitted to an ICU with organ failures pay an expensive toll&#58; the severe frailty that has a direct impact on the patient&#39;s recovery and return to his prior functional status&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">5</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">In line with recent international studies&#44;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">6</span></a> the FRAIL-ICU study has opened Pandora&#39;s box on the impact frailty has &#40;concept defined as a state of increasing vulnerability with poor resolution of homeostasis after a stressful event with an increased risk of adverse events&#44; falls&#44; delirium&#44; and disability&#41; on mortality&#44; and whether it should be part of the decision-making process at admission and further therapeutic support&#46;<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">7&#44;8</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">Assessing frailty in elderly patients can be useful&#44; but it is also important to assess it in young patients like the FRAIL-ICU says&#44; especially in patients with chronic conditions&#44; in those who have had prolonged prior admissions or in patients with criteria that contribute to frailty&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">1&#44;6</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">Frailty is associated with non-adjusted mortality&#44; like the FRAIL-ICU study shows&#44; and compromises the results and rehabilitation process of patients&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">1&#44;6</span></a> That is why it may be useful to screen frailty in order to identify it early in young patients&#44; be able to take preventive measures&#44; help identify individual goals&#44; and implement interventions to minimize the functional decline of critical conditions and reduce ICU stays&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Knowing about the existence of frailty can also help us adequate life-sustaining treatments at admission&#44; since patients with frailty make more decisions of limitation of life-sustaining treatment &#40;LLST&#41;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">3</span></a> and early palliative care strategies even while at their ICU stay&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">6</span></a> Still&#44; we need more studies on this regard to be able to determine the weight of frailty in the decisions of initiating or withdrawing life-sustaining treatments&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Frailty is useful together with other criteria for the assessment of those patients who may benefit the most from an ICU admission&#59; it should be measured whenever patients show a previously deteriorated functional status&#44; to implement an adequate action program capable of assessing treatment and the maximum level of organ support&#44; not to fall into futile diagnostic and therapeutic situations&#44; and ultimately to give the patient proper end-of-life care&#46;</p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Rubio Sanchiz O&#44; Fern&#225;ndez Fern&#225;ndez R&#46; &#191;Resulta &#250;til evaluar la fragilidad de los pacientes al ingreso en la unidad de cuidados intensivos &#40;UCI&#41;&#63; Med Intensiva&#46; 2019&#59;43&#58;393&#8211;394&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:8 [
            0 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Fragilidad en pacientes de 65 a&#241;os ingresados en cuidados intensivos &#40;FRAIL-ICU&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; L&#243;pez"
                            1 => "L&#46; Oteiza"
                            2 => "N&#46; L&#225;zaro"
                            3 => "N&#46;M&#46; Irazabal"
                            4 => "M&#46; Ibarz"
                            5 => "A&#46; Artigas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.medin.2019.01.010"
                      "Revista" => array:6 [
                        "tituloSerie" => "Med Intensiva"
                        "fecha" => "2019"
                        "volumen" => "43"
                        "paginaInicial" => "395"
                        "paginaFinal" => "401"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30905473"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "El anciano en la unidad de cuidados intensivos"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; L&#243;pez-Soto"
                            1 => "E&#46; Sacanella"
                            2 => "J&#46;M&#46; P&#233;rez-Castej&#243;n"
                            3 => "J&#46;M&#46; Nicol&#225;s"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.regg.2009.03.013"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Esp Geriatr Gerontol"
                        "fecha" => "2009"
                        "volumen" => "44"
                        "paginaInicial" => "27"
                        "paginaFinal" => "33"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19464761"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Short- and long-term outcomes of older patients in intermediate care units"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "O&#46; Torres"
                            1 => "E&#46; Francia"
                            2 => "V&#46; Longobardi"
                            3 => "I&#46; Gich"
                            4 => "S&#46; Benito"
                            5 => "D&#46; Ruiz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00134-006-0170-1"
                      "Revista" => array:6 [
                        "tituloSerie" => "Intensive Care Med"
                        "fecha" => "2006"
                        "volumen" => "32"
                        "paginaInicial" => "1052"
                        "paginaFinal" => "1059"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16791668"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Frailty in elderly people"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46; Clegg"
                            1 => "J&#46; Young"
                            2 => "S&#46; Iliffe"
                            3 => "M&#46; Olde-Rikkert"
                            4 => "K&#46; Rockwood"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(12)62167-9"
                      "Revista" => array:7 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2013"
                        "volumen" => "381"
                        "paginaInicial" => "752"
                        "paginaFinal" => "762"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23395245"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0022395614003100"
                          "estado" => "S300"
                          "issn" => "00223956"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Intensive care unit-acquired weakness"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46;D&#46; Griffiths"
                            1 => "J&#46;B&#46; Hall"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/CCM.0b013e318cc4b53"
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "2010"
                        "volumen" => "38"
                        "paginaInicial" => "779"
                        "paginaFinal" => "787"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20048676"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence and impact of frailty on mortality in elderly ICU patients&#58; a prospective&#44; multicenter&#44; observational study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Le Maguet"
                            1 => "A&#46; Roquilly"
                            2 => "S&#46; Lasocki"
                            3 => "K&#46; Asehnoune"
                            4 => "E&#46; Carise"
                            5 => "M&#46; Saint-Martin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00134-014-3253-4"
                      "Revista" => array:6 [
                        "tituloSerie" => "Intensive Care Med"
                        "fecha" => "2014"
                        "volumen" => "40"
                        "paginaInicial" => "674"
                        "paginaFinal" => "682"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24651884"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Limitation of life support techniques at admission to the intensive care unit&#58; a multicenter prospective cohort study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "O&#46; Rubio"
                            1 => "A&#46; Arnau"
                            2 => "S&#46; Cano"
                            3 => "C&#46; Subir&#224;"
                            4 => "B&#46; Balerdi"
                            5 => "M&#46;E&#46; Perea"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s40560-018-0283-y"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Intensive Care"
                        "fecha" => "2018"
                        "volumen" => "6"
                        "paginaInicial" => "24"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29686878"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Withholding or withdrawing of life-sustaining therapy in older adults &#40;&#8805;80 years&#41; admitted to the intensive care unit"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46; Guidet"
                            1 => "H&#46; Flaatten"
                            2 => "A&#46; Boumendil"
                            3 => "A&#46; Morandi"
                            4 => "F&#46; Andersen"
                            5 => "A&#46; Artigas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00134-018-5196-7"
                      "Revista" => array:6 [
                        "tituloSerie" => "Intensive Care Med"
                        "fecha" => "2018"
                        "volumen" => "44"
                        "paginaInicial" => "1027"
                        "paginaFinal" => "1038"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29774388"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21735727/0000004300000007/v1_201910040722/S2173572719301390/v1_201910040722/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "406"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Editorial"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21735727/0000004300000007/v1_201910040722/S2173572719301390/v1_201910040722/en/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572719301390?idApp=WMIE"
]
Share
Journal Information

Statistics

Follow this link to access the full text of the article

Editorial
Is it useful to assess patient frailty upon admission to the Intensive Care Unit (ICU)?
¿Resulta útil evaluar la fragilidad de los pacientes al ingreso en la unidad de cuidados intensivos (UCI)?
O. Rubio Sanchiz
Corresponding author
orubio@althaia.cat

Corresponding author.
, R. Fernández Fernández
Servicio de Medicina Intensiva, Althaia Xarxa Hospitalaria Universitaria de Manresa, Manresa, Barcelona, Spain
Read
3486
Times
was read the article
1638
Total PDF
1848
Total HTML
Share statistics
 array:24 [
  "pii" => "S2173572719301390"
  "issn" => "21735727"
  "doi" => "10.1016/j.medine.2019.04.006"
  "estado" => "S300"
  "fechaPublicacion" => "2019-10-01"
  "aid" => "1348"
  "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and SEMICYUC"
  "copyrightAnyo" => "2019"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "sco"
  "cita" => "Med Intensiva. 2019;43:393-4"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 58
    "formatos" => array:3 [
      "EPUB" => 12
      "HTML" => 24
      "PDF" => 22
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0210569119301329"
      "issn" => "02105691"
      "doi" => "10.1016/j.medin.2019.04.007"
      "estado" => "S300"
      "fechaPublicacion" => "2019-10-01"
      "aid" => "1348"
      "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; y SEMICYUC"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "sco"
      "cita" => "Med Intensiva. 2019;43:393-4"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 268
        "formatos" => array:3 [
          "EPUB" => 20
          "HTML" => 170
          "PDF" => 78
        ]
      ]
      "es" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">EDITORIAL</span>"
        "titulo" => "&#191;Resulta &#250;til evaluar la fragilidad de los pacientes al ingreso en la unidad de cuidados intensivos &#40;UCI&#41;&#63;"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "393"
            "paginaFinal" => "394"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Is it useful to assess patient frailty upon admission to the Intensive Care Unit &#40;ICU&#41;&#63;"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "O&#46; Rubio Sanchiz, R&#46; Fern&#225;ndez Fern&#225;ndez"
            "autores" => array:2 [
              0 => array:2 [
                "nombre" => "O&#46;"
                "apellidos" => "Rubio Sanchiz"
              ]
              1 => array:2 [
                "nombre" => "R&#46;"
                "apellidos" => "Fern&#225;ndez Fern&#225;ndez"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2173572719301390"
          "doi" => "10.1016/j.medine.2019.04.006"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572719301390?idApp=WMIE"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569119301329?idApp=WMIE"
      "url" => "/02105691/0000004300000007/v1_201910100635/S0210569119301329/v1_201910100635/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2173572719301407"
    "issn" => "21735727"
    "doi" => "10.1016/j.medine.2019.01.007"
    "estado" => "S300"
    "fechaPublicacion" => "2019-10-01"
    "aid" => "1315"
    "copyright" => "The Author&#40;s&#41;"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Med Intensiva. 2019;43:395-401"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 194
      "formatos" => array:3 [
        "EPUB" => 36
        "HTML" => 130
        "PDF" => 28
      ]
    ]
    "en" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
      "titulo" => "Frailty in patients over 65 years of age admitted to Intensive Care Units &#40;FRAIL-ICU&#41;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "395"
          "paginaFinal" => "401"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Fragilidad en pacientes mayores de 65 a&#241;os ingresados en cuidados intensivos &#40;FRAIL-ICU&#41;"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "S&#46; L&#243;pez Cuenca, L&#46; Oteiza L&#243;pez, N&#46; L&#225;zaro Mart&#237;n, M&#46;M&#46; Irazabal Jaimes, M&#46; Ibarz Villamayor, A&#46; Artigas, J&#46;A&#46; Lorente Balanza"
          "autores" => array:7 [
            0 => array:2 [
              "nombre" => "S&#46;"
              "apellidos" => "L&#243;pez Cuenca"
            ]
            1 => array:2 [
              "nombre" => "L&#46;"
              "apellidos" => "Oteiza L&#243;pez"
            ]
            2 => array:2 [
              "nombre" => "N&#46;"
              "apellidos" => "L&#225;zaro Mart&#237;n"
            ]
            3 => array:2 [
              "nombre" => "M&#46;M&#46;"
              "apellidos" => "Irazabal Jaimes"
            ]
            4 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Ibarz Villamayor"
            ]
            5 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Artigas"
            ]
            6 => array:2 [
              "nombre" => "J&#46;A&#46;"
              "apellidos" => "Lorente Balanza"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0210569119300415"
        "doi" => "10.1016/j.medin.2019.01.010"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569119300415?idApp=WMIE"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572719301407?idApp=WMIE"
    "url" => "/21735727/0000004300000007/v1_201910040722/S2173572719301407/v1_201910040722/en/main.assets"
  ]
  "asociados" => array:1 [
    0 => array:19 [
      "pii" => "S2173572719301407"
      "issn" => "21735727"
      "doi" => "10.1016/j.medine.2019.01.007"
      "estado" => "S300"
      "fechaPublicacion" => "2019-10-01"
      "aid" => "1315"
      "copyright" => "The Author&#40;s&#41;"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "fla"
      "cita" => "Med Intensiva. 2019;43:395-401"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 194
        "formatos" => array:3 [
          "EPUB" => 36
          "HTML" => 130
          "PDF" => 28
        ]
      ]
      "en" => array:12 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
        "titulo" => "Frailty in patients over 65 years of age admitted to Intensive Care Units &#40;FRAIL-ICU&#41;"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "tieneResumen" => array:2 [
          0 => "en"
          1 => "es"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "395"
            "paginaFinal" => "401"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "es" => array:1 [
            "titulo" => "Fragilidad en pacientes mayores de 65 a&#241;os ingresados en cuidados intensivos &#40;FRAIL-ICU&#41;"
          ]
        ]
        "contieneResumen" => array:2 [
          "en" => true
          "es" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "S&#46; L&#243;pez Cuenca, L&#46; Oteiza L&#243;pez, N&#46; L&#225;zaro Mart&#237;n, M&#46;M&#46; Irazabal Jaimes, M&#46; Ibarz Villamayor, A&#46; Artigas, J&#46;A&#46; Lorente Balanza"
            "autores" => array:7 [
              0 => array:2 [
                "nombre" => "S&#46;"
                "apellidos" => "L&#243;pez Cuenca"
              ]
              1 => array:2 [
                "nombre" => "L&#46;"
                "apellidos" => "Oteiza L&#243;pez"
              ]
              2 => array:2 [
                "nombre" => "N&#46;"
                "apellidos" => "L&#225;zaro Mart&#237;n"
              ]
              3 => array:2 [
                "nombre" => "M&#46;M&#46;"
                "apellidos" => "Irazabal Jaimes"
              ]
              4 => array:2 [
                "nombre" => "M&#46;"
                "apellidos" => "Ibarz Villamayor"
              ]
              5 => array:2 [
                "nombre" => "A&#46;"
                "apellidos" => "Artigas"
              ]
              6 => array:2 [
                "nombre" => "J&#46;A&#46;"
                "apellidos" => "Lorente Balanza"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "es" => array:9 [
          "pii" => "S0210569119300415"
          "doi" => "10.1016/j.medin.2019.01.010"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "es"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569119300415?idApp=WMIE"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572719301407?idApp=WMIE"
      "url" => "/21735727/0000004300000007/v1_201910040722/S2173572719301407/v1_201910040722/en/main.assets"
    ]
  ]
  "en" => array:12 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>"
    "titulo" => "Is it useful to assess patient frailty upon admission to the Intensive Care Unit &#40;ICU&#41;&#63;"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "393"
        "paginaFinal" => "394"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "O&#46; Rubio Sanchiz, R&#46; Fern&#225;ndez Fern&#225;ndez"
        "autores" => array:2 [
          0 => array:4 [
            "nombre" => "O&#46;"
            "apellidos" => "Rubio Sanchiz"
            "email" => array:1 [
              0 => "orubio@althaia.cat"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "R&#46;"
            "apellidos" => "Fern&#225;ndez Fern&#225;ndez"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Servicio de Medicina Intensiva&#44; Althaia Xarxa Hospitalaria Universitaria de Manresa&#44; Manresa&#44; Barcelona&#44; Spain"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "&#191;Resulta &#250;til evaluar la fragilidad de los pacientes al ingreso en la unidad de cuidados intensivos &#40;UCI&#41;&#63;"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">In this issue of <span class="elsevierStyleSmallCaps">Medicina</span><span class="elsevierStyleSmallCaps">Intensiva</span> we publish an interesting research on the prevalence of frailty in patients over 65 years old &#40;FRAIL-ICU&#41; that amounts to 35&#37;&#44;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">1</span></a> and its direct impact on mortality&#44; especially 1 month and 6 months after ICU discharge&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Probably some readers will wonder what sense does it make to measure frailty at the ICU&#44; what the profile of these patients should be&#44; and what the utility of all this may be&#63;</p><p id="par0015" class="elsevierStylePara elsevierViewall">In an era defined by the necessary efficiency of the healthcare system with more and more elderly patients being admitted to ICUs&#44; more complexity and comorbidities&#44; worse prior functional statuses and therefore&#44; frail and vulnerable&#44; the initial assessment of these patients has become more and more necessary&#46; And yet there is still uncertainty about the mortality results and quality of life of this subgroup of patients&#44; which is why we need objective predictive tools to help us decide what patients will benefit the most from the ICU stay&#44; and who won&#8217;t&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">2</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Are the traditional criteria based on the patient&#39;s age&#44; will&#44; severity&#44; prognosis&#44; quality of life&#44; presence of comorbidity&#44; etc&#46; any good anymore&#63;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Are we convinced about not making positive discrimination by admitting patients without a clear benefit&#8230; or negative discrimination by denying admission to patients just because they are too old&#63;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The severity of the disease that conditions the ICU admission and the patient&#39;s prior functional status&#44; rather than age itself&#44; are the key elements that determine the patient&#39;s overall mortality&#44; and long-term vital prognosis and functional status&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">3</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The traditional criteria used in younger patients&#44; with fewer comorbidities and diseases of one system only and acute decompensations cannot be used with complex patients or patients with several diseases or frail patients&#44; so new tools are needed and they need to be more adapted to the most prevalent type of patient with more multidimensional and holistic assessments of such patients&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">4</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">On the other hand&#44; it would be interesting to know what health results are patients really expecting&#44; above all complex patients and patients with multiple diseases&#44; but&#8230; what results do patients care the most&#63; Saving their lives at all cost is a good health outcome for them&#63; Or maybe recovering an acceptable functionality and quality of life after the ICU admission would be a better outcome&#63;</p><p id="par0045" class="elsevierStylePara elsevierViewall">It is hard to know or predict what is best for this or that patient&#44; and here the first step should always be knowing the patient&#39;s will after giving him honest information of what is at stake during an ICU admission&#46; Patients admitted to an ICU with organ failures pay an expensive toll&#58; the severe frailty that has a direct impact on the patient&#39;s recovery and return to his prior functional status&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">5</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">In line with recent international studies&#44;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">6</span></a> the FRAIL-ICU study has opened Pandora&#39;s box on the impact frailty has &#40;concept defined as a state of increasing vulnerability with poor resolution of homeostasis after a stressful event with an increased risk of adverse events&#44; falls&#44; delirium&#44; and disability&#41; on mortality&#44; and whether it should be part of the decision-making process at admission and further therapeutic support&#46;<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">7&#44;8</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">Assessing frailty in elderly patients can be useful&#44; but it is also important to assess it in young patients like the FRAIL-ICU says&#44; especially in patients with chronic conditions&#44; in those who have had prolonged prior admissions or in patients with criteria that contribute to frailty&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">1&#44;6</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">Frailty is associated with non-adjusted mortality&#44; like the FRAIL-ICU study shows&#44; and compromises the results and rehabilitation process of patients&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">1&#44;6</span></a> That is why it may be useful to screen frailty in order to identify it early in young patients&#44; be able to take preventive measures&#44; help identify individual goals&#44; and implement interventions to minimize the functional decline of critical conditions and reduce ICU stays&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Knowing about the existence of frailty can also help us adequate life-sustaining treatments at admission&#44; since patients with frailty make more decisions of limitation of life-sustaining treatment &#40;LLST&#41;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">3</span></a> and early palliative care strategies even while at their ICU stay&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">6</span></a> Still&#44; we need more studies on this regard to be able to determine the weight of frailty in the decisions of initiating or withdrawing life-sustaining treatments&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Frailty is useful together with other criteria for the assessment of those patients who may benefit the most from an ICU admission&#59; it should be measured whenever patients show a previously deteriorated functional status&#44; to implement an adequate action program capable of assessing treatment and the maximum level of organ support&#44; not to fall into futile diagnostic and therapeutic situations&#44; and ultimately to give the patient proper end-of-life care&#46;</p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Rubio Sanchiz O&#44; Fern&#225;ndez Fern&#225;ndez R&#46; &#191;Resulta &#250;til evaluar la fragilidad de los pacientes al ingreso en la unidad de cuidados intensivos &#40;UCI&#41;&#63; Med Intensiva&#46; 2019&#59;43&#58;393&#8211;394&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:8 [
            0 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Fragilidad en pacientes de 65 a&#241;os ingresados en cuidados intensivos &#40;FRAIL-ICU&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; L&#243;pez"
                            1 => "L&#46; Oteiza"
                            2 => "N&#46; L&#225;zaro"
                            3 => "N&#46;M&#46; Irazabal"
                            4 => "M&#46; Ibarz"
                            5 => "A&#46; Artigas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.medin.2019.01.010"
                      "Revista" => array:6 [
                        "tituloSerie" => "Med Intensiva"
                        "fecha" => "2019"
                        "volumen" => "43"
                        "paginaInicial" => "395"
                        "paginaFinal" => "401"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30905473"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "El anciano en la unidad de cuidados intensivos"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; L&#243;pez-Soto"
                            1 => "E&#46; Sacanella"
                            2 => "J&#46;M&#46; P&#233;rez-Castej&#243;n"
                            3 => "J&#46;M&#46; Nicol&#225;s"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.regg.2009.03.013"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Esp Geriatr Gerontol"
                        "fecha" => "2009"
                        "volumen" => "44"
                        "paginaInicial" => "27"
                        "paginaFinal" => "33"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19464761"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Short- and long-term outcomes of older patients in intermediate care units"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "O&#46; Torres"
                            1 => "E&#46; Francia"
                            2 => "V&#46; Longobardi"
                            3 => "I&#46; Gich"
                            4 => "S&#46; Benito"
                            5 => "D&#46; Ruiz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00134-006-0170-1"
                      "Revista" => array:6 [
                        "tituloSerie" => "Intensive Care Med"
                        "fecha" => "2006"
                        "volumen" => "32"
                        "paginaInicial" => "1052"
                        "paginaFinal" => "1059"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16791668"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Frailty in elderly people"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46; Clegg"
                            1 => "J&#46; Young"
                            2 => "S&#46; Iliffe"
                            3 => "M&#46; Olde-Rikkert"
                            4 => "K&#46; Rockwood"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(12)62167-9"
                      "Revista" => array:7 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2013"
                        "volumen" => "381"
                        "paginaInicial" => "752"
                        "paginaFinal" => "762"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23395245"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0022395614003100"
                          "estado" => "S300"
                          "issn" => "00223956"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Intensive care unit-acquired weakness"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46;D&#46; Griffiths"
                            1 => "J&#46;B&#46; Hall"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/CCM.0b013e318cc4b53"
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "2010"
                        "volumen" => "38"
                        "paginaInicial" => "779"
                        "paginaFinal" => "787"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20048676"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence and impact of frailty on mortality in elderly ICU patients&#58; a prospective&#44; multicenter&#44; observational study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Le Maguet"
                            1 => "A&#46; Roquilly"
                            2 => "S&#46; Lasocki"
                            3 => "K&#46; Asehnoune"
                            4 => "E&#46; Carise"
                            5 => "M&#46; Saint-Martin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00134-014-3253-4"
                      "Revista" => array:6 [
                        "tituloSerie" => "Intensive Care Med"
                        "fecha" => "2014"
                        "volumen" => "40"
                        "paginaInicial" => "674"
                        "paginaFinal" => "682"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24651884"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Limitation of life support techniques at admission to the intensive care unit&#58; a multicenter prospective cohort study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "O&#46; Rubio"
                            1 => "A&#46; Arnau"
                            2 => "S&#46; Cano"
                            3 => "C&#46; Subir&#224;"
                            4 => "B&#46; Balerdi"
                            5 => "M&#46;E&#46; Perea"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s40560-018-0283-y"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Intensive Care"
                        "fecha" => "2018"
                        "volumen" => "6"
                        "paginaInicial" => "24"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29686878"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Withholding or withdrawing of life-sustaining therapy in older adults &#40;&#8805;80 years&#41; admitted to the intensive care unit"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46; Guidet"
                            1 => "H&#46; Flaatten"
                            2 => "A&#46; Boumendil"
                            3 => "A&#46; Morandi"
                            4 => "F&#46; Andersen"
                            5 => "A&#46; Artigas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00134-018-5196-7"
                      "Revista" => array:6 [
                        "tituloSerie" => "Intensive Care Med"
                        "fecha" => "2018"
                        "volumen" => "44"
                        "paginaInicial" => "1027"
                        "paginaFinal" => "1038"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29774388"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21735727/0000004300000007/v1_201910040722/S2173572719301390/v1_201910040722/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "406"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Editorial"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21735727/0000004300000007/v1_201910040722/S2173572719301390/v1_201910040722/en/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572719301390?idApp=WMIE"
]
Article information
ISSN: 21735727
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 9 8 17
2024 October 36 39 75
2024 September 43 33 76
2024 August 47 29 76
2024 July 41 32 73
2024 June 49 36 85
2024 May 37 25 62
2024 April 43 35 78
2024 March 32 29 61
2024 February 32 37 69
2024 January 31 47 78
2023 December 31 41 72
2023 November 37 41 78
2023 October 33 27 60
2023 September 34 37 71
2023 August 35 16 51
2023 July 33 21 54
2023 June 28 15 43
2023 May 35 39 74
2023 April 16 17 33
2023 March 34 26 60
2023 February 24 31 55
2023 January 22 34 56
2022 December 35 22 57
2022 November 42 30 72
2022 October 44 20 64
2022 September 28 27 55
2022 August 43 34 77
2022 July 57 28 85
2022 June 30 21 51
2022 May 60 31 91
2022 April 59 28 87
2022 March 43 53 96
2022 February 25 31 56
2022 January 40 37 77
2021 December 41 43 84
2021 November 29 37 66
2021 October 33 63 96
2021 September 14 21 35
2021 August 12 47 59
2021 July 10 32 42
2021 June 23 21 44
2021 May 23 47 70
2021 April 66 91 157
2021 March 63 30 93
2021 February 44 22 66
2021 January 30 14 44
2020 December 26 11 37
2020 November 26 13 39
2020 October 22 23 45
2020 July 14 7 21
2020 June 24 8 32
2020 May 15 4 19
2020 April 21 10 31
2020 March 16 9 25
2020 February 21 19 40
2020 January 4 5 9
2019 November 1 0 1
2019 September 2 4 6
Show all

Follow this link to access the full text of the article

Idiomas
Medicina Intensiva (English Edition)
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?