• Bharath Kumar Tirupakuzhi Vijayaraghavan, Aasiyah Rashan, Lakshmi Ranganathan, Ramesh Venkataraman, Swagata Tripathy, Devachandran Jayakumar, Pratheema Ramachandran, Zubair Umer Mohamed, Sindhu Balakrishnan, Nagarajan Ramakrishnan, Rashan Haniffa, Abi Beane, AdhikariNeill K JNKJInterdepartmental Division of Critical Care Medicine, University of Toronto, Canada; Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Canada., Nicolette de Keizer, Nazir Lone, and IRIS collaborative.
• Department of Critical Care Medicine, Apollo Hospitals, Chennai, India; The George Institute for Global Health, New Delhi, India. Electronic address: bharath@icuconsultants.com.
• J Crit Care. 2024 Apr 1; 80: 154509154509.

PurposeWe aimed to study the prevalence of frailty, evaluate risk factors, and understand impact on outcomes in India.MethodsThis was a prospective registry-embedded cohort study across 7 intensive care units (ICUs) and included adult patients anticipated to stay for at least 48 h. Primary exposure was frailty, as defined by a score ≥ 5 on the Clinical Frailty Scale and primary outcome was ICU mortality. Secondary outcomes included in-hospital mortality and resource utilization. We used generalized linear models to evaluate risk factors and model association between frailty and outcomes.Results838 patients were included, with median (IQR) age 57 (42,68) yrs.; 64.8% were male. Prevalence of frailty was 19.8%. Charlson comorbidity index (OR:1.73 (95%CI:1.39,2.15)), Subjective Global Assessment categories mild/moderate malnourishment (OR:1.90 (95%CI:1.29, 2.80)) and severe malnourishment (OR:4.76 (95% CI:2.10,10.77)) were associated with frailty. Frailty was associated with higher odds of ICU mortality (adjusted OR:2.04 (95% CI:1.25,3.33)), hospital mortality (adjusted OR:2.36 (95%CI:1.45,3.84)), development of stage2/3 AKI (unadjusted OR:2.35 (95%CI:1.60, 3.43)), receipt of non-invasive ventilation (unadjusted OR:2.68 (95%CI:1.77, 4.03)), receipt of vasopressors (unadjusted OR:1.47 (95%CI:1.04, 2.07)), and receipt of kidney replacement therapy (unadjusted OR:3.15 (95%CI:1.90, 5.17)).ConclusionsFrailty is common among critically ill patients in India and is associated with worse outcomes.Study RegistrationCTRI/2021/02/031503.Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.

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