Frailty as a predictor of short- and long-term mortality in critically ill older medical patients

Purpose: Frailty is a common condition among critically ill patients. Usually evaluated in a mixed population of medical, cardiac and surgical patients, we aimed to assess the impact of frailty on short- and long-termmortality exclusively in critically ill older medical patients. Materials and methods: Weincluded 285 patients aged >= 70 years admitted to ICU (2009-2017). Comorbidities, severity scores, treatment intensity and complications were recorded. Pre-hospital frailty, measured by Clinical Frailty Scale (CFS), was defined as a score >= 5 according to this scale. Results: Prevalence of frailty (CFS >= 5) of 18.6%. Frail patients were more likely to be female (64.2% vs. 35.6%, p < .001) or suffer from heart failure (17% vs. 6%,p =.021). Apache II score was higher in frail than in non-frail patients (27.4 +/- 7.1 vs. 24.8 +/- 8.6,p =.041). Age, comorbidities, treatment intensity, complications, and ICU and hospital length of stay were similar between frail and non-frail patients. Life-sustaining treatment limitation wasmore frequent in frail patients (47.2% vs. 20.7%,p < .001). Except for ICU mortality, frailtywas an independent predictor of short- and long-term mortality after adjustment for sociodemographic, comorbidities, severity scores, treatment intensity and complications. Conclusions: Frailty (CFS >= 5) was independently associated with short- and long-termmortality in older patients admitted to ICU exclusively due to a medical reason. (C) 2019 Elsevier Inc. All rights reserved.