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Conclusion: Prior BB treatment have limited impact on the severity of acute circulatory failure in septic shock and is not associated with increased mortality despite the underlying frailty of patients.
However, we speculate that the large differences in early outcome in our subjects are likely driven by underlying frailty in the older population, which is characterized by vulnerability to acute stressors and is a consequence of decline in overall function and physiologic reserve [35].
Much research has taken place in understanding the pathophysiology and mechanisms underlying frailty; 5 6 however, assessing frailty reliably remains problematic and is a research priority.
Mechanisms and pathophysiology underlying frailty have not been fully elucidated, thus absolute consensus on an operational definition for frailty is lacking.
The 76+ age group is especially at an increased risk for motor vehicle crashes due to underlying frailty and fragility, medical conditions, medications, and functional impairments (McGwin et al 2000; Langford et al 2006).
Consequently, medical management that focuses solely on the immediate causes of hospitalization may have little impact on underlying frailty, and leave patients more susceptible to poor short and long-term outcomes, such as unplanned rehospitalizations and institutionalization.
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Performance assessments, such as grip strength, peak expiratory flow (PEF), chair stands, and walking speed, are largely determined by physiological functions that typically decline with age and may underlie frailty (Cooper et al. 2010).
However, mortality is not always the clean, binary endpoint it is often considered to be: it can often be predicted from the time of admission by other factors, including physiological age, degree of severity of the disease, underlying diseases, frailty, or comorbidities.
Taking actions that are meaningful to you will counteract the sense of helplessness or loss of control that often underlies emotional frailty.
FA is used to identify the structure underlying all the frailty indicators and provides more internal reliability to the measure by controlling for measurement error, as it analyzes only the variability in an indicator that is shared among the other indicators (common variance without error or unique variance) while PCA assumes that all variability in an indicator should be used in the analysis.
Even though the PReCaP possibly provides some psychological benefits to hospitalized patients at risk of functional decline, we should aim to further study prognostic factors and underlying gradients of frailty or risk of functional decline, thereby allowing and improving the design of integrated interventions that can mediate this risk and improve patient outcomes.
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