Association of combined frailty and nutritional risk assessment with mortality in critically ill patients

The objective of this study was to evaluate whether frailty and high nutritional risk, when considered together, were predictors of in-hospital mortality in critically ill patients.

Prospective cohort study. Adult and older patients of both sexes admitted to the ICU for at least 48 h were included. Clinical follow-up was maintained from ICU admission until in-hospital death, allowing for prospective analysis of events. Demographic and clinical data were collected from medical records. Frailty was assessed using the Clinical Frailty Scale (CFS), considering the patient's condition prior to admission, and nutritional risk was assessed using the modified Nutrition Risk in the Critically Ill (mNUTRIC) score.

A total of 145 critically ill patients were evaluated. High nutritional risk was present in 47.6% (n = 69) and frailty in 37.9% (n = 55) of the sample. In the adjusted model, the combination of frailty and high nutritional risk (CFS ≥5 + mNUTRIC ≥5) was significantly associated with a 2.68-fold increase in the odds of in-hospital mortality (OR 2.68; 95% CI 1.01-7.11; p = 0.047). Frailty or nutritional risk alone did not show a significant association with mortality in the adjusted analysis.

Our data suggest that the co-occurrence of frailty and high nutritional risk is an independent predictor of in-hospital mortality in critically ill patients. These findings highlight the importance of supplementing nutritional screening with frailty assessment to identify patients at higher risk of adverse outcomes.