• Muhammet Cemal Kizilarslanoglu, Ramazan Civelek, Mustafa Kemal Kilic, Fatih Sumer, Hacer Dogan Varan, Ozgur Kara, Gunes Arik, Melda Turkoglu, Gulbin Aygencel, and Zekeriya Ulger.
• Department of Internal Medicine, Division of Geriatrics, Gazi University School of Medicine, 06560, Besevler, Ankara, Turkey. drcemalk@yahoo.com.tr.
• Aging Clin Exp Res. 2017 Apr 1; 29 (2): 247-255.

AimThe study aimed to investigate the effects of frailty on clinical outcomes of patients in an intensive care unit (ICU).MethodsIn this prospective study, 122 patients (59 frail, 37 pre-frail and 26 robust) were included. A frailty index (FI) derived from comprehensive geriatric assessment parameters was used for the evaluation. The FI score of ≤0.25 was considered as robust, 0.25-0.40 as pre-frail and >0.40 as frail. The prognostic effects of FI were investigated and FI and APACHE II and SOFA scores, the prognostic scores using in ICU, were compared.ResultsMedian age of the patients was 71 years old and 50.8 % were male. ICU mortality rate and median length of stay (LOS) were 51.6 % and 8 days (min-max: 1-148), respectively. ICU mortality was higher (69.2, 56.8 and 40.7 %, respectively, p = 0.040) and median overall survival was lower in frail group compared to pre-frail and robust subjects (23, 31 and 140 days, p = 0.013, respectively). Long term mortality over 3 and 6 months in frail patients were 80.8 and 84.6 %, respectively and significantly higher than others. Multivariate analysis showed that LOS in ICU (HR 1.067, 95 % CI 1.021-1.114), SOFA score (HR 1.272, 95 % CI 1.096-1.476) and FI (HR 39.019, 95 % CI 1.235-1232.537) were the independent correlates for ICU mortality (p = 0.004, p = 0.002 and 0.038, respectively). There was a weak but statistically significant positive correlation between APACHE II and FI scores (r = 0.190, p = 0.036).ConclusionsFI may be used as a predictor for the evaluation of elderly patients' clinical outcomes in ICUs.

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