Association between the Clinical Frailty Scale and Neurological Outcomes in Out-of-Hospital Cardiac Arrest: A Retrospective Study

Haw Hwai ¹, Chien-Kai Wu ², Chien-Yu Chi ³

⁰Department of Emergency Medicine, National Taiwan University Hospital, National Taiwan University Medical College, 100 Taipei.

Reviews in Cardiovascular Medicine +

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March 31, 2025

View abstract on PubMed

Summary

Premorbid frailty, measured by the Clinical Frailty Scale (CFS), significantly impacts neurological outcomes after out-of-hospital cardiac arrest (OHCA). Lower CFS scores (≤4) are linked to better recovery, highlighting frailty as a key prognostic factor.

Area Of Science

Critical Care Medicine
Neurology
Geriatrics

Background

Frailty is a state of increased vulnerability to stressors.
Premorbid frailty assessment is crucial for predicting patient outcomes.
Out-of-hospital cardiac arrest (OHCA) presents significant challenges for neurological recovery.

Purpose Of The Study

To investigate the association between premorbid frailty and neurological prognosis in OHCA patients.
To determine the predictive value of the Clinical Frailty Scale (CFS) for neurological outcomes post-OHCA.
To identify factors influencing neurological recovery after resuscitation from OHCA.

Main Methods

Retrospective analysis of 595 adult OHCA patients from 2006-2020.
Frailty assessed using the Clinical Frailty Scale (CFS).
Primary outcome: favorable neurological performance (CPC score ≤2) at discharge.

Main Results

Lower CFS scores (3.2 ± 1.5) were associated with favorable neurological outcomes compared to poor outcomes (4.5 ± 1.8).
Favorable outcomes decreased as CFS scores increased.
Independent predictors of worse neurological outcomes included CFS >4, age >70, malignancy history, high epinephrine dose, and low arterial pH.

Conclusions

Clinical Frailty Scale (CFS) values ≤4 are independently associated with favorable neurological outcomes after OHCA.
Frailty is a significant independent predictor of neurological recovery post-cardiac arrest.
Early assessment of frailty may aid in prognostication and patient management strategies.

Keywords:

clinical frailty scale neurological outcomes out-of-hospital cardiac arrest