6 research outputs found
Relationship between the Clinical Frailty Scale and short-term mortality in patients ≥ 80 years old acutely admitted to the ICU: a prospective cohort study.
BACKGROUND: The Clinical Frailty Scale (CFS) is frequently used to measure frailty in critically ill adults. There is wide variation in the approach to analysing the relationship between the CFS score and mortality after admission to the ICU. This study aimed to evaluate the influence of modelling approach on the association between the CFS score and short-term mortality and quantify the prognostic value of frailty in this context. METHODS: We analysed data from two multicentre prospective cohort studies which enrolled intensive care unit patients ≥ 80 years old in 26 countries. The primary outcome was mortality within 30-days from admission to the ICU. Logistic regression models for both ICU and 30-day mortality included the CFS score as either a categorical, continuous or dichotomous variable and were adjusted for patient's age, sex, reason for admission to the ICU, and admission Sequential Organ Failure Assessment score. RESULTS: The median age in the sample of 7487 consecutive patients was 84 years (IQR 81-87). The highest fraction of new prognostic information from frailty in the context of 30-day mortality was observed when the CFS score was treated as either a categorical variable using all original levels of frailty or a nonlinear continuous variable and was equal to 9% using these modelling approaches (p < 0.001). The relationship between the CFS score and mortality was nonlinear (p < 0.01). CONCLUSION: Knowledge about a patient's frailty status adds a substantial amount of new prognostic information at the moment of admission to the ICU. Arbitrary simplification of the CFS score into fewer groups than originally intended leads to a loss of information and should be avoided. Trial registration NCT03134807 (VIP1), NCT03370692 (VIP2)
The Socioeconomic Welfare of Urban Green Areas and Parks; A Literature Review of Available Evidence
Urban green areas present a lucid example for the harmonious co-existence of the artificial and natural environments best illustrated by their interdependence and interconnection in urban spaces. Urban green areas are essential for the health and wellbeing of citizens. The present study aimed to investigate those multiple benefits for citizens that arise through the existence of urban green areas, as well as important policy dimensions that should be considered when designing the expansion of urban green spaces in urban development. The study was based on a literature review to examine for available evidence on the benefit levels derived by the existence of urban green areas. An extended literature review was followed by a structured review, based on specific inclusion and exclusion criteria, which partly followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search was conducted in two databases, and a total of 1674 articles and abstracts were identified through the database searches. After removing 114 duplicates, 1560 records were initially screened based on title and abstract. Following inclusion and exclusion criteria, 14 articles were incorporated in the structured review and a total of 47 in the extended review. The extended literature review identified 33 additional articles examining aspects of benefits that did not fall under the pre-established inclusion and exclusion criteria used in the structured review, such as health benefits and other social parameters associated with urban green spaces. The selected studies were allocated in five principal groups according to study types: three of the them consisted of studies employing “willingness to pay” (WTP) methods, five were based on property values, two studies assigned monetary values, while another two assigned CO2 values, and, finally, two studies were based on qualitative criteria. The results indicated benefits to citizens and increased welfare levels gained by the existence of urban green areas. The conducted review revealed a number of findings and recommendations that could direct future research and urban policy. Those hints could assist local authorities as well as stakeholders in order to measure and assess the benefits of green spaces and urban parks and promote measures and programs to assist their further deployment
Public Perceptions of the Socioeconomic Importance of Urban Green Areas in the Era of COVID-19: A Case Study of a Nationwide Survey in Greece
Considering the emerging challenges posed by the spread of COVID-19, this study was designed to evaluate citizens’ perceptions of the role of urban green areas in the era of COVID-19 in Greece. The evaluation was based on the implementation of an electronic questionnaire survey through the Google Forms platform, which was conducted nationwide. The survey was conducted in 2020 and 735 responses were collected in total based on 14 structured questions. Among the key findings of the study, of notable importance is that citizens considered urban green areas as an important means of improving public health, while citizens were willing to accept an increase of EUR1 to EUR20 in their municipal taxes for improving the services offered by the urban green areas. Results indicate that in a period of both climatic and public health crises, healthy and green urban environments can play a seminal role for alleviating and mitigating different challenges and impacts, while at the same time ensuring sustainability of urban ecosystems. A certain necessity arises for investigating the socioeconomic importance of urban green areas both from an ecosystemic and public health perspective considering the novel challenges of COVID-19 to public policy and decision making
Public Perceptions of the Socioeconomic Importance of Urban Green Areas in the Era of COVID-19: A Case Study of a Nationwide Survey in Greece
Considering the emerging challenges posed by the spread of COVID-19, this study was designed to evaluate citizens’ perceptions of the role of urban green areas in the era of COVID-19 in Greece. The evaluation was based on the implementation of an electronic questionnaire survey through the Google Forms platform, which was conducted nationwide. The survey was conducted in 2020 and 735 responses were collected in total based on 14 structured questions. Among the key findings of the study, of notable importance is that citizens considered urban green areas as an important means of improving public health, while citizens were willing to accept an increase of EUR1 to EUR20 in their municipal taxes for improving the services offered by the urban green areas. Results indicate that in a period of both climatic and public health crises, healthy and green urban environments can play a seminal role for alleviating and mitigating different challenges and impacts, while at the same time ensuring sustainability of urban ecosystems. A certain necessity arises for investigating the socioeconomic importance of urban green areas both from an ecosystemic and public health perspective considering the novel challenges of COVID-19 to public policy and decision making
Relationship between the Clinical Frailty Scale and short-term mortality in patients ≥ 80 years old acutely admitted to the ICU: a prospective cohort study
Background: The Clinical Frailty Scale (CFS) is frequently used to measure frailty in critically ill adults. There is wide variation in the approach to analysing the relationship between the CFS score and mortality after admission to the ICU. This study aimed to evaluate the influence of modelling approach on the association between the CFS score and short-term mortality and quantify the prognostic value of frailty in this context. Methods: We analysed data from two multicentre prospective cohort studies which enrolled intensive care unit patients ≥ 80 years old in 26 countries. The primary outcome was mortality within 30-days from admission to the ICU. Logistic regression models for both ICU and 30-day mortality included the CFS score as either a categorical, continuous or dichotomous variable and were adjusted for patient’s age, sex, reason for admission to the ICU, and admission Sequential Organ Failure Assessment score. Results: The median age in the sample of 7487 consecutive patients was 84 years (IQR 81–87). The highest fraction of new prognostic information from frailty in the context of 30-day mortality was observed when the CFS score was treated as either a categorical variable using all original levels of frailty or a nonlinear continuous variable and was equal to 9% using these modelling approaches (p < 0.001). The relationship between the CFS score and mortality was nonlinear (p < 0.01). Conclusion: Knowledge about a patient’s frailty status adds a substantial amount of new prognostic information at the moment of admission to the ICU. Arbitrary simplification of the CFS score into fewer groups than originally intended leads to a loss of information and should be avoided. Trial registration NCT03134807 (VIP1), NCT03370692 (VIP2