Predicting weaning failure in critically ill older patients: secondary analysis of a national multicenter prospective cohort in Türkiye
Özet
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.
Anahtar kelimeler
Atıf için künye
KASAPOĞLU, U. S., Yazicioglu Mocin, O., Tuncay, E., Gungor, S., ARIKAN, H., Ediboglu, O., Teke, N. H., Aydin, E. M., Kucuk, B., Saglam, D. A., Celik, D., Yetkin, O., Lakadamyali, H., Altun, U., Yurttas, A., Altın, C., Yilmaz, B., Erdal Donmez, G., Alay, G. H., … Kurtulus, S. (2026). Predicting weaning failure in critically ill older patients: secondary analysis of a national multicenter prospective cohort in Türkiye. BMC Geriatrics, 26(1). https://doi.org/10.1186/s12877-026-07545-0
BibTeX
@article{kasapoglu2026-154046,
author = {KASAPOĞLU, UMUT SABRİ and Yazicioglu Mocin, Ozlem and Tuncay, Eylem and Gungor, Sinem and ARIKAN, HÜSEYİN and Ediboglu, Ozlem and Teke, Nazlı Huma and Aydin, Eda Macit and Kucuk, Berkay and Saglam, Dursun Ali and Celik, Deniz and Yetkin, Ozkan and Lakadamyali, Huseyin and Altun, Ugur and Yurttas, Ahmet and Altın, Cemile and Yilmaz, Baris and Erdal Donmez, Gul and Alay, Gulcin Hilal and Kolay, Feyzullah and Kasisari, Mahmut Baran and Serefoglu, Rezan and Gul, Fethi and Tekin, Esra and Kocak, Hicran and Sabaz, Mehmet Suleyman and Cankaya, Esra and Bektas, Melike and Inci, Seda Seven and Yanatma, Seher and Duzgun, Ahmet and Acun Delen, Leman and BIÇAKCIOĞLU, MURAT and Ozer, Ayse Belin and Avlagi, Lutfiye Serap and Yilmaz Selimoglu, Alkim Gizem and KÜÇÜK, AHMET OĞUZHAN and Ozdemir Simsek, Duygu and Kilicaslan, Banu and Akinci, Seda Banu and Colak, Mucahid and Alım, Mete and Altuntas, Gulsum and YILDIZ, FARUK and İNAL, VOLKAN and Aydin, Kaniye and Gok, Mehmet Gokhan and Onuk, Sevda and Ozkok, Huseyin and Yaylaci, Selcuk and Aydin, Emre and Yilmaz Aydin, Fatma and Dogan, Omer and Ozcengiz, Dilek and Tas, Neslihan and Dogan, Omer Tamer and Mingsar, Eren and Gonderen, Kamil and Yildiz, Ismail and Iliaz, Sinem and Ucar, Hatice Arzu and Capar, Ayse and Baslilar, Seyma and Bayraktar, Yesim Serife and Cebeci, Yasemin and Ozcelik, Zerrin and Ozgun, Pinar and Savas, Nilgun and Kollu, Korhan and Gultekin, Hamza and Erer, Aysen and Demirer Aydemir, Ferhan and Hanci Yilmazturk, Pervin and Uysal, Ahmet and Temel, Esra and Tekin, Veysi and Celik, Hande and Kara, Aysen and Yalcinkaya, Erdem and Karakurt, Sait and Mermit, Buket and Yuksel, Beyza and Akdag, Busra Nur and Sağlam, Leyla and Balbay, Oner Abidin and Coskuner, Huseyin and Demir, Nalan and Tunc, Seyma and Ocal, Nesrin and Ozturk Sahin, Burcu and Senturk Topaloglu, Elvan and Ozgur, Eylem Sercan and Polat Yulug, Demet and Oksuzler Kizilbay, Gozde and Kayhan, Oguzhan and DEMİRKIRAN, OKTAY and Uluc, Kamuran and Kasimoglu, Nur and Tomruk Erdem, Aysegul and Savas, Asli Melek and Kurtulus, Serif},
title = {Predicting weaning failure in critically ill older patients: secondary analysis of a national multicenter prospective cohort in Türkiye},
journal = {BMC Geriatrics},
year = {2026},
volume = {26},
number = {1},
issn = {1471-2318},
doi = {10.1186/s12877-026-07545-0},
url = {https://akademik.atauni.edu.tr/yayinlar/154046-predicting-weaning-failure-in-critically-ill-older-patients-secondary-analysis}
}