[Frailty in intensive care medicine]

Area of Science:

• Geriatric Medicine
• Intensive Care Medicine
• Public Health

Background:

• Global demographic shifts are increasing the number of elderly patients in ICUs.
• Chronological age is an inadequate predictor of mortality and functional recovery post-critical illness.
• Frailty, a measure of biological vulnerability, offers superior risk stratification for critically ill older adults.

Purpose of the Study:

• To systematically review the literature on frailty in intensive care medicine.
• To understand frailty's definition, pathophysiology, assessment, epidemiology, and management.
• To highlight the importance of frailty assessment for risk stratification and patient-centered care.

Main Methods:

• A systematic literature search was performed across PubMed, Scopus, and Web of Science.
• The search focused on frailty in the context of intensive care medicine.
• Key areas included definition, pathophysiology, assessment tools, epidemiology, and management strategies.

Main Results:

• Frailty is a multidimensional geriatric syndrome prevalent in 26.6-43.1% of ICU admissions.
• The Clinical Frailty Scale (CFS) is a practical tool for assessing frailty in acute and intensive care.
• Frailty independently predicts increased mortality, ventilator weaning failure, delirium, and persistent functional dependence.

Conclusions:

• Systematic frailty assessment is fundamental for accurate prognosis and shared decision-making.
• It identifies high-risk patients who can benefit from function-preserving interventions.
• Frailty assessment guides adapted care but does not directly alter mortality or functional recovery rates.