The clinical frailty scale for the assessment of frailty in octogenarians in the intensive care unit

Abstract

Objective: Increased frailty is shown to be related to vulnerability to adverse health outcomes. The objective of the study was to assess the usability of frailty identified using the Clinical Frailty Scale (CFS) in patients aged 80 years and older admitted to the intensive care unit (ICU).

Materials and Methods: We conducted a retrospective screening of the octogenarian patients admitted to the ICU between January 1 and October 31, 2023. After excluding the postoperative patients, we recorded the demographic characteristics and comorbidities, APACHE II scores, Charlson Comorbidity Index, CFS scores, general admission reasons, and discharge patterns from ICU.

Results: The median age of the 156 patients in the study was 85, with 51.9% being female. The median APACHE II score was 18 (12–28), and the median CFS score was 5 (1–9). The CFS score categorized 37 patients as non-frail, 37 as pre-frail, and 82 as frail. The frail group exhibited statistically significant elevations in age, albumin levels, APACHE II scores, and comorbidities, including dementia, cerebrovascular disease, and cancer. The CFS score, age of 90 years or older, presence of pressure ulcers, APACHE II score, and acute kidney injury were associated with an increased risk of mortality. However, analysis of survival rates across frailty categories revealed no significant differences among the groups (p: 0.348).

Conclusion: Although the survival analysis revealed no major differences among non-frail, pre-frail, and frail groups, frailty was associated with risk of death in patients aged 80 and older, making it a potentially simple tool for doctors to predict outcomes.