Frailty in Critically Ill Cancer Patients in a Lower-middle Income Country-Prevalence, Risk Factors, and Impact on...

Frailty is a multifaceted condition characterized by diminished physiological reserves, reduced resilience, and heightened vulnerability to stressors. Its prevalence among critically ill patients, particularly those with cancer, poses unique challenges due to pre-existing impairments and comorbidities. This study aims to evaluate the prevalence of frailty in critically ill cancer patients, identify associated risk factors, and assess its impact on acute clinical outcomes and 90 days postdischarge health-related quality of life (HRQOL).

A prospective, single-center cohort study was conducted between October 2021 and September 2022, enrolling critically ill cancer patients admitted to the intensive care unit (ICU). Frailty was assessed using the clinical frailty scale (CFS) within 48 hours of ICU admission. Data on demographics, illness severity [acute physiology and chronic health evaluation II (APACHE II) score], nutritional status, and clinical outcomes were collected. Ninety days postdischarge HRQOL was evaluated using the EuroQol 5-dimension 5-level (EQ-5D-5L) questionnaire.

All 627 enrolled patients were identified as frail, with 79.7% categorized as having mild frailty. Age (p = 0.006) and higher Charlson comorbidity index (CCI) scores (p < 0.001) were significant risk factors for frailty. Frailty severity was significantly associated with a prolonged requirement for vasoactive support, invasive ventilation, ICU and hospital stay, ICU readmission, delayed mobilization, and increased mortality (p < 0.05). Ninety days postdischarge, patients with higher frailty grades reported worsened mobility, self-care, usual activities, pain/discomfort, and lower subjective health scores (p < 0.05).

Frailty is highly prevalent among critically ill cancer patients. Increasing frailty adversely impacts clinical outcomes and postdischarge HRQOL. Tailored interventions are essential to address the complex needs of this vulnerable population.

Sundaramurthy SK, Murali Rajagopalan TS, Balakrishnan P, Ramakrishnan N, Dominic Savio R. Frailty in Critically Ill Cancer Patients in a Lower-middle Income Country-Prevalence, Risk Factors, and Impact on Acute Clinical Outcomes and Postdischarge Health-related Quality of Life: A Single Center Study. Indian J Crit Care Med 2026;30(1):19-26.