Epigeic spiders of the pastures of northern Wielkopolska

The fauna of epigeic spiders (Araneae) occurring on three different types of pastures in northern Wielkopolska was analysed. Studies were conducted from May 1992 to October 1993. The 18,995 specimens collected were classified as belonging to 137 species and 17 families. The family Linyphiidae proved the richest in species while Lycosidae was the most abundantly in terms of number of specimens. Zoocenological analysis of spider communities showed their differentiation testifying to differences in the sites studied. The dominants were: 1) Osowo Stare (Site 1): Pardosa palustris, 2) Sycyn Dolny (Site 2): Xerolycosa miniata, P. palustris, Xysticus kochi, 3) Brqczewo (Site 3): Erigone dentipalpis, P. palustris. Seasonal changes of dominance of the species at each site were established. A comparison of changes of the species' dominances in the years 1992 and 1993 disclosed similar values of the individual dominance coefficient at the sites in Osowo Stare and Brqczewo. This result indicates the occurrence of the process of stabilization of these biocenoses and a tendency to equilibrium in the environment. The least stable proved to be the site at Sycyn Dolny. Analysis of the seasonal dynamics of epigeic spider communities was also made by determining the mean number of species at each site in the two years of study. The highest number of species was noted in spring. It is interesting to note the appearance of species which are rare or very rare in Poland such as: Lepthyphantes insignis, Ostearius melanopygius, Enoplogriatha mordax and Enoplognatha oelandica

Spiders (Araneae) of the trunk layer in the upper forest limit in the Karkonosze national park =Pająki (Araneae) warstwy korowej górnej granicy lasu na terenie Karkonoskiego Parku Narodowego

30130

Spider communities in the contact zone between open areas and spruce forest in the Karkonosze national park =Zgrupowania pająków w strefie przejściowej pomiędzy terenami otwartymi a borem świerkowym w Karkonoskim Parku Narodowym

30931

Epigeic spiders of the pastures of northern Wielkopolska

Volume: 20Start Page: 1End Page: 2

Frailty increases mortality among patients ≥ 80 years old treated in Polish ICUs

Background: The increasing population of very old intensive care patients (VIPs) is a major challenge currently faced by clinicians and policymakers. Reliable indicators of VIPs’ prognosis and purposefulness of their admission to the intensive care unit (ICU) are urgently needed. Methods: This is a report from the Polish sample of the VIP1 multicentre cohort study (NCT03134807). Patients ≥ 80 years of age admitted to the ICU were included in the study. Information on the type and reason for admission, demographics, utilisation of ICU procedures, ICU length of stay, organ dysfunction and the decision to apply end-of-life care was collected. The primary objective was to investigate the impact of frailty syndrome on ICU and 30-day survival of VIPs. Frailty was assessed with the Clinical Frailty Scale (≥ 5 points on a scale of 1–9). Results: We enrolled 272 participants with a median age of 84 (81–87) years. Frailty was diagnosed in 170 (62.5%) patients. The ICU and 30-day survival rates were equal to 54.6% and 47.3% respectively. Three variables were found to significantly increase the odds of death in the ICU in a multiple logistic regression model: SOFA score (OR = 1.16; 95%CI 1.16–1.24), acute mode of admission (OR = 5.1; 95%CI 1.67–15.57) and frailty (OR = 2.25; 95%CI 1.26–4.01). Conclusion: Measuring frailty in critically ill older adults can facilitate making more informed clinical decisions and help avoid futile interventions.Background: The increasing population of very old intensive care patients (VIPs) is a major challenge currently facedby clinicians and policymakers. Reliable indicators of VIPs’ prognosis and appropriateness of their admission to theintensive care unit (ICU) are urgently needed. Methods: This is a report from the Polish sample of the VIP1 multicentre cohort study (NCT03134807). Patients≥ 80 years of age admitted to the ICU were included in the study. Information on the type and reason for admission,demographics, utilisation of ICU procedures, ICU length of stay, organ dysfunction and the decision to apply end-of--life care was collected. The primary objective was to investigate the impact of frailty syndrome on ICU and 30-daysurvival of VIPs. Frailty was assessed with the Clinical Frailty Scale (≥ 5 points on a scale of 1–9). Results: We enrolled 272 participants with a median age of 84 (81–87) years. Frailty was diagnosed in 170 (62.5%)patients. The ICU and 30-day survival rates were equal to 54.6% and 47.3% respectively. Three variables were found tosignificantly increase the odds of death in the ICU in a multiple logistic regression model, namely: SOFA score (OR = 1.16;95% CI: 1.16–1.24); acute mode of admission (OR = 5.1; 95% CI: 1.67–15.57); and frailty (OR = 2.25; 95% CI: 1.26–4.01). Conclusion: Measuring frailty in critically ill older adults can facilitate making more informed clinical decisions andhelp avoid futile interventions

Sepsis at ICU admission does not decrease 30-day survival in very old patients: a post-hoc analysis of the VIP1 multinational cohort study

Background: The number of intensive care patients aged ≥ 80 years (Very old Intensive Care Patients; VIPs) is growing. VIPs have high mortality and morbidity and the benefits of ICU admission are frequently questioned. Sepsis incidence has risen in recent years and identification of outcomes is of considerable public importance. We aimed to determine whether VIPs admitted for sepsis had different outcomes than those admitted for other acute reasons and identify potential prognostic factors for 30-day survival. Results: This prospective study included VIPs with Sequential Organ Failure Assessment (SOFA) scores ≥ 2 acutely admitted to 307 ICUs in 21 European countries. Of 3869 acutely admitted VIPs, 493 (12.7%) [53.8% male, median age 83 (81-86) years] were admitted for sepsis. Sepsis was defined according to clinical criteria; suspected or demonstrated focus of infection and SOFA score ≥ 2 points. Compared to VIPs admitted for other acute reasons, VIPs admitted for sepsis were younger, had a higher SOFA score (9 vs. 7, p < 0.0001), required more vasoactive drugs [82.2% vs. 55.1%, p < 0.0001] and renal replacement therapies [17.4% vs. 9.9%; p < 0.0001], and had more life-sustaining treatment limitations [37.3% vs. 32.1%; p = 0.02]. Frailty was similar in both groups. Unadjusted 30-day survival was not significantly different between the two groups. After adjustment for age, gender, frailty, and SOFA score, sepsis had no impact on 30-day survival [HR 0.99 (95% CI 0.86-1.15), p = 0.917]. Inverse-probability weight (IPW)-adjusted survival curves for the first 30 days after ICU admission were similar for acute septic and non-septic patients [HR: 1.00 (95% CI 0.87-1.17), p = 0.95]. A matched-pair analysis in which patients with sepsis were matched with two control patients of the same gender with the same age, SOFA score, and level of frailty was also performed. A Cox proportional hazard regression model stratified on the matched pairs showed that 30-day survival was similar in both groups [57.2% (95% CI 52.7-60.7) vs. 57.1% (95% CI 53.7-60.1), p = 0.85]. Conclusions: After adjusting for organ dysfunction, sepsis at admission was not independently associated with decreased 30-day survival in this multinational study of 3869 VIPs. Age, frailty, and SOFA score were independently associated with survival

Withholding or withdrawing of life-sustaining therapy in older adults (≥ 80 years) admitted to the intensive care unit

PURPOSE: To document and analyse the decision to withhold or withdraw life-sustaining treatment (LST) in a population of very old patients admitted to the ICU. METHODS: This prospective study included intensive care patients aged ≥ 80 years in 309 ICUs from 21 European countries with 30-day mortality follow-up. RESULTS: LST limitation was identified in 1356/5021 (27.2%) of patients: 15% had a withholding decision and 12.2% a withdrawal decision (including those with a previous withholding decision). Patients with LST limitation were older, more frail, more severely ill and less frequently electively admitted. Patients with withdrawal of LST were more frequently male and had a longer ICU length of stay. The ICU and 30-day mortality were, respectively, 29.1 and 53.1% in the withholding group and 82.2% and 93.1% in the withdrawal group. LST was less frequently limited in eastern and southern European countries than in northern Europe. The patient-independent factors associated with LST limitation were: acute ICU admission (OR 5.77, 95% CI 4.32-7.7), Clinical Frailty Scale (CFS) score (OR 2.08, 95% CI 1.78-2.42), increased age (each 5 years of increase in age had a OR of 1.22 (95% CI 1.12-1.34) and SOFA score [OR of 1.07 (95% CI 1.05-1.09 per point)]. The frequency of LST limitation was higher in countries with high GDP and was lower in religious countries. CONCLUSIONS: The most important patient variables associated with the instigation of LST limitation were acute admission, frailty, age, admission SOFA score and country. TRIAL REGISTRATION: ClinicalTrials.gov (ID: NTC03134807)