• J Alberto Silva-Obregón, Manuel Quintana-Díaz, Sonia Saboya-Sánchez, Carlos Marian-Crespo, M Ángel Romera-Ortega, Carlos Chamorro-Jambrina, Alfonso Estrella-Alonso, and Eva María Andrés-Esteban.
• Department of Intensive Care Medicine, Hospital Universitario de Guadalajara, Spain. Electronic address: jasoeres@gmail.com.
• J Crit Care. 2020 Feb 1; 55: 79-85.

PurposeFrailty is a common condition among critically ill patients. Usually evaluated in a mixed population of medical, cardiac and surgical patients, we aimed to assess the impact of frailty on short- and long-term mortality exclusively in critically ill older medical patients.Materials And MethodsWe included 285 patients aged≥70 years admitted to ICU (2009-2017). Comorbidities, severity scores, treatment intensity and complications were recorded. Pre-hospital frailty, measured by Clinical Frailty Scale (CFS), was defined as a score ≥ 5 according to this scale.ResultsPrevalence of frailty (CFS ≥ 5) of 18.6%. Frail patients were more likely to be female (64.2% vs. 35.6%, p < .001) or suffer from heart failure (17% vs. 6%,p = .021). Apache II score was higher in frail than in non-frail patients (27.4 ± 7.1 vs. 24.8 ± 8.6,p = .041). Age, comorbidities, treatment intensity, complications, and ICU and hospital length of stay were similar between frail and non-frail patients. Life-sustaining treatment limitation was more frequent in frail patients (47.2% vs. 20.7%,p < .001). Except for ICU mortality, frailty was an independent predictor of short- and long-term mortality after adjustment for sociodemographic, comorbidities, severity scores, treatment intensity and complications.ConclusionsFrailty (CFS ≥ 5) was independently associated with short- and long-term mortality in older patients admitted to ICU exclusively due to a medical reason.Copyright © 2019 Elsevier Inc. All rights reserved.

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