Assessing frailty in the intensive care unit: A reliability and validity study.

Area of Science:

• Critical Care Medicine
• Geriatrics
• Clinical Assessment

Background:

• Frailty is a significant predictor of outcomes in critically ill patients.
• Accurate pre-ICU frailty assessment is crucial for patient management.
• The Clinical Frailty Scale (CFS) is a validated tool for assessing frailty.

Purpose of the Study:

• To describe pre-ICU frailty in critically ill patients using the Clinical Frailty Scale (CFS).
• To evaluate the reliability of CFS scoring by different healthcare professionals and methods.

Main Methods:

• Prospective enrollment of 150 adult patients admitted to two ICUs in Hamilton, Canada.
• Clinical Frailty Scale (CFS) scores generated by a Research Coordinator (RC) using chart review, family interview, and patient interview.
• Assessment of inter-rater and intra-rater reliability for CFS scoring among RC, Occupational Therapist (OT), and Geriatrics Resident (GR).

Main Results:

• CFS scores showed high reliability across chart reviews by RC, OT, and GR (p>0.05).
• No significant differences were found between RC chart review/patient interview and the final RC score.
• A significant difference was observed between RC family interview and the final RC score (p<0.01).
• A weak, non-significant association was found between increased CFS scores and ICU/hospital mortality.

Conclusions:

• Clinical Frailty Scale (CFS) scores can be reliably generated using medical chart review.
• ICU clinicians and research staff can reliably complete CFS assessments.
• Pre-ICU frailty assessment using CFS is feasible and reliable in critical care settings.