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Assessing the Usefulness and Validity of Frailty Markers in Critically Ill Adults.


ABSTRACT:

Rationale

Identifying frailty by the presence of a critical number of frailty markers has been difficult to operationalize in the intensive care unit (ICU), where patients often cannot complete performance measures or answer complex questions.

Objectives

To assess the construct and predictive validity of a questionnaire-based approach to identifying frailty in adult ICU patients.

Methods

We conducted an observational cohort study of adults admitted to a medical or surgical ICU at one of two hospitals in New York. We asked patients or surrogates about demographic information, frailty markers, and prehospital disability status. ICU physicians completed the Clinical Frailty Scale (CFS), a judgment-based frailty assessment tool. We examined the relationship between individual frailty markers, CFS, and demographic correlates of frailty such as age, prehospital living arrangement, and prehospital disability. We assessed the predictive validity of possible frailty phenotypes, using hospital and 6-month outcomes.

Results

Among 95 study participants (mean age [SD], 57.1 [17.5] yr), 80% reported one or more of seven frailty markers (median [interquartile range], 3 [1-4]). The most common frailty markers were impaired mobility (60%), impaired physical activity (60%), and decreased strength (44.2%). Patients with more frailty markers were older (mean age [SD] of those with at least three frailty markers: 62.3 [17.7] vs. 51.6 [15.8] yr; P?ConclusionsAsking patients or surrogates about frailty markers may be a valid approach to identifying critically ill adults with a frailty phenotype associated with increased risk of adverse outcomes. Larger studies measuring frailty markers may provide insight into factors that impact short- and long-term outcomes after ICU admission.

SUBMITTER: Hope AA 

PROVIDER: S-EPMC5566304 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

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Publications

Assessing the Usefulness and Validity of Frailty Markers in Critically Ill Adults.

Hope Aluko A AA   Hsieh S J SJ   Petti Alex A   Hurtado-Sbordoni Mariana M   Verghese Joe J   Gong Michelle Ng MN  

Annals of the American Thoracic Society 20170601 6


<h4>Rationale</h4>Identifying frailty by the presence of a critical number of frailty markers has been difficult to operationalize in the intensive care unit (ICU), where patients often cannot complete performance measures or answer complex questions.<h4>Objectives</h4>To assess the construct and predictive validity of a questionnaire-based approach to identifying frailty in adult ICU patients.<h4>Methods</h4>We conducted an observational cohort study of adults admitted to a medical or surgical  ...[more]

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