Relationship between community walking ability and in-hospital mortality in elderly patients with sepsis: a single-center retrospective cohort study

Purpose: To examine the association of a simple frailty assessment, Life Space (LS), with in-hospital mortality in elderly patients with sepsis. Methods: We used data from a single hospital between 2014 and 2017. We included elderly patients (age >= 65 years) admitted to the intensive care unit (ICU) with sepsis, as defined by sepsis-3 criteria. Frailty assessment was based on a patient's ability to independently go out of the house before the ICU admission. We termed this dichotomous score as Life Space. The primary outcome was in-hospital mortality. Logistic regression was used to investigate the association of LS with each outcome after adjusting for age, sex, and Sequential Organ Failure Assessment score. Results: Of the 335 participants included in the final analysis, 121 (36%) were classified as frail. LS-positive patients had a higher in-hospital mortality (adjusted odds ratio (aOR) 2.32; 95% confidence interval (CI) 1.36-3.96; P=0.002) than did LS-negative patients. We observed similar patterns in six sets of sensitivity analyses after accounting for different confounders. In subgroup analyses, significant interactions were observed in participants with versus those without treatment limitations (aOR 1.02 vs. 2.66, P for interaction=0.042). Conclusions: In this single-center study, frailty assessed by LS was independently associated with a higher in-hospital mortality.