Mitigating the effects of severe illness and critical care: lessons for frailty management.

Prof Kenneth Rockwood is Director of Geriatric Medicine Research at Dalhousie University, Canada and serves on the International Advisory Panel of Age and Ageing journal. shutterstock_162603902

People who are frail have accumulated more health deficits than have others of the same age. Deficit accumulation occurs when damage either goes unremoved (or unavoided) or unrepaired.   That’s why rational management of frailty needs to pay attention both to reducing the exposure to damage, and to increasing its removal or repair.  The same can be brought to mitigating the consequences of acute illness and its treatment. A recent study of patients admitted to an Intensive Care Unit (ICU) shows how.

In the before/after controlled trial of a bundled set of interventions to improve outcomes of critically ill patients (296 aged 19-late 80s, 187 of whom were intubated) Balas et al. were able to reduce delirium duration and mobilize patients early. The study was conducted in several critical care units in a large tertiary care teaching hospital. Continue reading