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Background: Traditional predictors of weaning outcomes primarily focus on acute illness severity and physiological parameters, while geriatric vulnerability domains such as frailty, functional dependence, and nutritional risk are often overlooked. Evidence regarding the incremental prognostic value of these domains for predicting weaning failure in critically ill older patients remains limited. This study aimed to evaluate the association between pre-admission frailty, functional status, comorbidity burden, and acute organ dysfunction with weaning failure in critically ill patients aged ≥ 65 years, and to compare their prognostic contribution with traditional severity scores. Methods: This study is a secondary analysis of a national, multicenter, prospective observational cohort conducted across adult ICUs in Türkiye. Consecutive ICU patients aged ≥ 65 years who required invasive mechanical ventilation for more than 24 h were included. Multivariable logistic regression was used to identify factors independently associated with weaning failure. Weaning failure was defined as the need for reintubation within 7 days after extubation, death during the weaning process, or persistent requirement for invasive mechanical ventilation at day 90. Model discrimination was assessed using the area under the receiver operating characteristic curve (AUC). Results: A total of 647 critically ill older patients were included in the study. Weaning failure occurred in 347 patients (53.6%). There was no significant difference in age between patients with weaning failure and those successfully weaned. Patients with weaning failure had significantly higher frailty scores, greater comorbidity burden, more severe organ dysfunction, higher nutritional risk, and worse functional dependency. In the final multivariable logistic regression model, higher Clinical Frailty Scale (CFS) (aOR = 1.26 per point; 95% CI = 1.16–1.38) and higher Sequential Organ Failure Assessment (SOFA) score (aOR = 1.12 per point; 95% CI = 1.06–1.19) were independently associated with weaning failure. Conclusions: In critically ill older patients, frailty and early organ dysfunction were the factors most strongly associated with weaning failure, whereas chronological age alone showed limited prognostic value, supporting a shift from age-based to vulnerability-based risk assessment.
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Kaynak: BMC GERIATRICS
Anahtar Kelimeler (WoS)
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Makale Bilgileri
Dergi
BMC Geriatrics
ISSN
1471-2318
Yıl
2026
/ 4. ay
Cilt / Sayı
26
/ 1
Makale Türü
Özgün Makale
Hakemlik
Hakemli
Endeks
SCI-Expanded
JCR Quartile
Q2
Yayın Dili
İngilizce
Kapsam
Uluslararası
Toplam Yazar
101 kişi
Erişim Türü
Elektronik
Alan
Sağlık Bilimleri Temel Alanı
Yoğun Bakım
YÖKSİS Yazar Kaydı
Yazar Adı
KASAPOĞLU UMUT SABRİ,YILDIZ FARUK,YAZICIOĞLU MOÇİN ÖZLEM,İNAL VOLKAN,TUNÇAY EYLEM,GÜNGÖR SİNEM,EDİBOĞLU ÖZLEM,MACİT AYDIN EDA,KÜÇÜK BERKAY,YETKİN ÖZKAN,LAKADAMYALI HÜSEYİN,YURTTAŞ AHMET,ALTIN CEMİLE,ALAY GÜLÇİN HİLAL,KAŞISARI MAHMUT BARAN,GÜL FETHİ,KOÇAK HİCRAN,SABAZ MEHMET SÜLEYMAN,ÇANKAYA ESRA,BEKTAŞ KÖSESOY MELİKE,YANATMA SEHER,DÜZGÜN AHMET,ACUN DELEN LEMAN,BIÇAKCIOĞLU MURAT,ÖZER AYŞE BELİN,AVLAĞI LÜTFİYE SERAP,YILMAZ ALKIM GİZEM,KÜÇÜK AHMET OĞUZHAN,KILIÇASLAN BANU,AKINCI SEDA BANU,ÇOLAK MÜCAHİD,AYDEMİR YUSUF,ALTUNTAŞ GÜLSÜM,AYDIN KANİYE,GÖK MEHMET GÖKHAN,ONUK SEVDA,ÖZKÖK HÜSEYİN,YAYLACI SELÇUK,AYDIN EMRE,YILMAZ AYDIN FATMA,DOĞAN ÖMER,ÖZCENGİZ DİLEK,TAŞ NESLİHAN,DOĞAN ÖMER TAMER,MİNGSAR EREN,GÖNDEREN KAMİL,YILDIZ İSMAİL,İLİAZ SİNEM,UÇAR HATİCE ARZU,ÇAPAR AYŞE,BAŞLILAR ŞEYMA,BAYRAKTAR YEŞİM ŞERİFE,CEBECİ YASEMİN,ÖZÇELİK ZERRİN,SAVAŞ NİLGÜN,KOLLU KORHAN,GÜLTEKİN HAMZA,ERER AYŞEN,DEMİRER AYDEMİR FERHAN,HANCI YILMAZTÜRK PERVİN,UYSAL AHMET,TEMEL ESRA,TEKİN VEYSİ,ÇELİK HANDE,KARA AYŞEN,YALÇINKAYA ERDEM,KARAKURT SAİT,MERMİT BUKET,YÜKSEL BEYZA,AKDAĞ NUR BÜŞRA,SAĞLAM LEYLA,BALBAY ÖNER ABİDİN,COŞKUNER HÜSEYİN,DEMİR NALAN,ÖCAL NESRİN,ÖZTÜRK ŞAHİN BURCU,ŞENTÜRK TOPALOĞLU ELVAN,ÖZGÜR EYLEM SERCAN,POLAT YULUĞ DEMET,ÖKSÜZLER GÖZDE,KAYHAN OĞUZHAN,DEMİRKIRAN OKTAY,ULUÇ KAMURAN,TOMRUK ERDEM AYŞEGÜL,MELEK ASLI,KURTULUŞ ŞERİF
YÖKSİS ID
9588252