Dataset Information

The Clinical Frailty Scale for mortality prediction of old acutely admitted intensive care patients: a meta-analysis of individual patient-level data.

ABSTRACT:

Background

This large-scale analysis pools individual data about the Clinical Frailty Scale (CFS) to predict outcome in the intensive care unit (ICU).

Methods

A systematic search identified all clinical trials that used the CFS in the ICU (PubMed searched until 24th June 2020). All patients who were electively admitted were excluded. The primary outcome was ICU mortality. Regression models were estimated on the complete data set, and for missing data, multiple imputations were utilised. Cox models were adjusted for age, sex, and illness acuity score (SOFA, SAPS II or APACHE II).

Results

12 studies from 30 countries with anonymised individualised patient data were included (n = 23,989 patients). In the univariate analysis for all patients, being frail (CFS ≥ 5) was associated with an increased risk of ICU mortality, but not after adjustment. In older patients (≥ 65 years) there was an independent association with ICU mortality both in the complete case analysis (HR 1.34 (95% CI 1.25-1.44), p < 0.0001) and in the multiple imputation analysis (HR 1.35 (95% CI 1.26-1.45), p < 0.0001, adjusted for SOFA). In older patients, being vulnerable (CFS 4) alone did not significantly differ from being frail. After adjustment, a CFS of 4-5, 6, and ≥ 7 was associated with a significantly worse outcome compared to CFS of 1-3.

Conclusions

Being frail is associated with a significantly increased risk for ICU mortality in older patients, while being vulnerable alone did not significantly differ. New Frailty categories might reflect its "continuum" better and predict ICU outcome more accurately.

Trial registration

Open Science Framework (OSF: https://osf.io/8buwk/ ).

SUBMITTER: Bruno RR

PROVIDER: S-EPMC10155148 | biostudies-literature | 2023 May

REPOSITORIES: biostudies-literature

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Publications

The Clinical Frailty Scale for mortality prediction of old acutely admitted intensive care patients: a meta-analysis of individual patient-level data.

Bruno Raphael Romano RR Wernly Bernhard B Bagshaw Sean M SM van den Boogaard Mark M Darvall Jai N JN De Geer Lina L de Gopegui Miguelena Pablo Ruiz PR Heyland Daren K DK Hewitt David D Hope Aluko A AA Langlais Emilie E Le Maguet Pascale P Montgomery Carmel L CL Papageorgiou Dimitrios D Seguin Philippe P Geense Wytske W WW Silva-Obregón J Alberto JA Wolff Georg G Polzin Amin A Dannenberg Lisa L Kelm Malte M Flaatten Hans H Beil Michael M Franz Marcus M Sviri Sigal S Leaver Susannah S Guidet Bertrand B Boumendil Ariane A Jung Christian C

Annals of intensive care 20230503 1

<h4>Background</h4>This large-scale analysis pools individual data about the Clinical Frailty Scale (CFS) to predict outcome in the intensive care unit (ICU).<h4>Methods</h4>A systematic search identified all clinical trials that used the CFS in the ICU (PubMed searched until 24th June 2020). All patients who were electively admitted were excluded. The primary outcome was ICU mortality. Regression models were estimated on the complete data set, and for missing data, multiple imputations were uti ...[more]

PMID: 37133796

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Dataset Information

The Clinical Frailty Scale for mortality prediction of old acutely admitted intensive care patients: a meta-analysis of individual patient-level data.

Background

Methods

Results

Conclusions

Trial registration

Publications

The Clinical Frailty Scale for mortality prediction of old acutely admitted intensive care patients: a meta-analysis of individual patient-level data.

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