The Impact of Frailty on Cardiopulmonary Resuscitation Adverse Outcomes in Patients Requiring Code Blue Activation

The aim of this study was to determine the independent association of frailty with cardiopulmonary resuscitation and predictive factors in patients triggering code blue response

Study Overview

• Status: Recruiting
• Conditions: Frailty; Cardiac Arrest; Respiratory Arrest
• Intervention / Treatment: Other: Edmonton frailty scale calculation

Detailed Description

Out-of-hospital cardiac arrest remains an important cause of death in developed countries with an average adult survival rate of 5.6% . In contrast, in-hospital cardiac arrests have been reported to have a survival rate between 4.1% and 40% and several factors have been shown to affect survival rates. These factors include patient and physiologic factors such as age, initial rhythm disturbance and duration of cardiopulmonary resuscitation (CPR), as well as hospital and logistic factors such as location and timing of the arrest.Code blue (CC) is the emergency call and management systems for respiratory or cardiac arrest. CC is used worldwide for the same emergency and the same color. The CC is the organization that initiates certain systems to initiate, perform and terminate the intervention of the designated responsible team. CC is given by a doctor (emergency, anesthesia and reanimation, internal medicine, pediatrics, intensive care specialist), anesthesia technician, nurse. The CC team is a team that prevents clinical death quickly, effectively and safely to provide life-saving support to patients. The CC team provides immediate intervention to patients, their relatives and all hospital staff. While the prevalence of frailty is 10-25% in the elderly aged 65 years and over, it increases to 30-45% in those aged 85 years and over. There are no definitive data on the prevalence of frail elderly in Turkey. The definition of frail elderly syndrome emerged as a concept in geriatrics and gerontology in the 1980s in response to the growing need for a unifying diagnosis among seemingly disparate and nonspecific disease presentations in older adults. The main symptoms are weight loss, weakness, fatigue and immobility, while the main findings are sarcopenia, osteopenia, malnutrition, impaired balance and gait, and slow walking. The importance of the definition of frailty comes from the fact that it is an alarm table used to indicate the susceptibility of the elderly to conditions such as clinical deterioration, falls and mortality over time. Frailty is a syndrome that can be prevented or at least postponed if diagnosed at an early stage. In fact, the frail elderly constitute a group vulnerable to adverse events with poor prognosis Mortality and complication rates are higher in elderly surgical patients than in younger surgical patients. Surgical risk is even higher in frail elderly patients. Regardless of the type of surgery and whatever assessment tool is used, the presence of frailty is associated with an approximately two- to threefold increased risk of adverse surgical outcome. Numerous studies have shown that frailty is a risk factor for postoperative complications, longer hospital stay and loss of functional independence at discharge. Therefore, identifying older patients with frailty offers opportunities to provide improved risk stratification and targeted interventions to improve outcomes The Edmonton Frailty Scale, a performance-based multidimensional frailty assessment tool, was designed by non-geriatricians in the west to help assess and screen frail older patients in primary care and at the bedside. It consists of 11 questions relating to nine different domains such as awareness, social support, mood, nutrition and functional performance. The result correlates well with the clinical impression of geriatricians through detailed history and physical examination.

• Study Type: Observational
• Enrollment (Estimated): 2

Contacts and Locations

• Study Contact: Name: zeliha tuncel, ass prof; Phone Number: +905053577483; Email: zelihalara@yahoo.com

Study Locations

• Turkey (Türkiye)
  • Umraniye
    • Istanbul, Umraniye, Turkey (Türkiye), 34734
      • Recruiting
      • Umraniye Education and Research Hospital
      • Contact: ZELİHA TUNCEL, Association prof; Phone Number: +905053577483; Email: zelihalara@yahoo.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: N/A

• Sampling Method: Probability Sample

Study Population

Adult patients with hospitalization and those who are not inpatients (in the outpatient clinic system) requiring Code Blue will be included in the study.

Description

Inclusion Criteria:

• pediatric patients

Exclusion Criteria:

• pregnant patients

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Edmonton frailty scale ≥ 7; The frailty status of the patients will be assessed using the Edmonton frailty scale. According to the Edmonton frailty scale; (0-5): not frail; (6-7): sensitive; (8-9): slightly fragile; (10-11): moderately fragile,; (12-17): extremely fragile	Other: Edmonton frailty scale calculation; The frailty status of the patients will be assessed using the Edmonton frailty scale. According to the Edmonton frailty scale; (0-5): not frail; (6-7): sensitive; (8-9): slightly fragile; (10-11): moderately fragile,; (12-17): extremely fragile
Edmonton frailty scale below 7; The frailty status of the patients will be assessed using the Edmonton frailty scale. According to the Edmonton frailty scale; (0-5): not frail; (6-7): sensitive; (8-9): slightly fragile; (10-11): moderately fragile,; (12-17): extremely fragile	Other: Edmonton frailty scale calculation; The frailty status of the patients will be assessed using the Edmonton frailty scale. According to the Edmonton frailty scale; (0-5): not frail; (6-7): sensitive; (8-9): slightly fragile; (10-11): moderately fragile,; (12-17): extremely fragile

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
code blue reason	comorbid disease and dog usage	years
duration of CPR time	between the time of giving the blue code and the end of CPR	hours

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
the airway equipment used	intubation, supraglottic airway devices, tracheostomy, cricothyroidectomy, fiberbronchoscopy	days
mortality and morbidity	presence and duration of intensive care unit stay	mounts

Collaborators and Investigators

• Sponsor: Umraniye Education and Research Hospital

Study record dates

Study Major Dates

• Study Start (Estimated): December 1, 2025
• Primary Completion (Estimated): April 30, 2026
• Study Completion (Estimated): May 30, 2026

Study Registration Dates

• First Submitted: December 29, 2023
• First Submitted That Met QC Criteria: May 6, 2024
• First Posted (Actual): May 8, 2024

Study Record Updates

• Last Update Posted (Actual): November 19, 2025
• Last Update Submitted That Met QC Criteria: November 16, 2025
• Last Verified: November 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Cardiovascular Diseases; Pathologic Processes; Heart Diseases; Respiratory Tract Diseases; Respiration Disorders; Signs and Symptoms, Respiratory; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Frailty; Apnea; Heart Arrest
• Other Study ID Numbers: UERH-AR-ZT-05

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No