• Utino Taniguchi Leandro L Hospital Sírio Libanês, Rua Daher Cutait 69, 01308-060 São Paulo, Brazil; Emergency Medicine Discipline, Hospital das Clínicas HCFMUSP, Faculdad, Quazi Ibrahim, Azevedo Luciano Cesar Pontes de LCP Hospital Sírio Libanês, Rua Daher Cutait 69, 01308-060 São Paulo, Brazil; Emergency Medicine Discipline, Hospital das Clínicas HCFMUSP, Henry T Stelfox, and Sean M Bagshaw.
• Hospital Sírio Libanês, Rua Daher Cutait 69, 01308-060 São Paulo, Brazil; Emergency Medicine Discipline, Hospital das Clínicas HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, Av Enéas de Carvalho Aguiar 255 Sala 5023, 05403-000 São Paulo, Brazil; Brazilian Research in Intensive Care Network (BRICNet), São Paulo, Brazil. Electronic address: leandro.taniguchi@hc.fm.usp.br.
• J Crit Care. 2020 Oct 1; 59: 143-148.

PurposeWe aimed to describe the association of two frailty screening tools, the validated Clinical Frailty Scale (CFS) score and the recently described modified Frailty Index (mFI) in critically ill patients.Materials And MethodsWe performed a post-hoc analysis of a multicenter cohort of patients admitted to six Canadian Intensive Care Units (ICU) between 2010 and 2011. Frailty was screened using the CFS and the mFI. Concordance between these tools was evaluated, as well as discrimination and predictive ability for clinical outcomes after adjustments.ResultsThe cohort included 421 patients. Prevalence of frailty was 32.8% with the CFS and 39.2% with the mFI. However, concordance between the two tools was low [(intraclass correlation of 0.37; 95% confidence interval [CI] 0.29-0.45) and partial Spearman rank correlation of 0.38 (95% CI 0.29-0.47)]. Hospital and 1-year mortality, as well as dependency after discharge and hospital readmission, were greater for frail compared to non-frail patients screened with the use of both tools.ConclusionWhile the CFS and mFI showed low concordance, both showed good discrimination and predictive validity for hospital mortality. Both tools identify a subgroup of frail patients more likely to have worse clinical outcomes.Copyright © 2020 Elsevier Inc. All rights reserved.

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