Reliability of the Clinical Frailty Scale in very elderly ICU patients: a prospective European study

Annals of Intensive Care

Ariane Boumendil¹  Antonio Artigas²  Hans Flaatten³  Finn H. Andersen⁴  Maurizio Cecconi⁵  Sandra Oeyen⁶  Dylan W. de Lange⁷  Joerg C. Schefold⁸  Jesper Fjølner⁹  Christian Jung^1,10  Michael Joannidis^1,11  Yuriy Nalapko^1,12  Rui Moreno^1,13  Muhammed Elhadi^1,14  Sten Walther^1,15  Ximena Watson^1,16  Tilemachos Zafeiridis^1,17  Wojciech Szczeklik^1,18  Brian Marsh^1,19  Susannah Leaver^2,20  Bertrand Guidet^2,21 

[1] AP-HP, Hôpital Saint-Antoine, Service de Réanimation, 75012, Paris, France;Deparment of Intensive Care Medicine, CIBER Enfermedades Respiratorias, Corporacion Sanitaria Universitaria Parc Tauli, Autonomous University of Barcelona, Sabadell, Spain;Department of Anaesthesia and Intensive Care, Dep of Clinical Medicine, Haukeland University Hospital Bergen Norway, University of Bergen, 5019, Bergen, Norway;Department of Anaesthesia and Intensive Care, Ålesund Hospital, Ålesund, Norway;Dep of Circulation and Medical Imaging, NTNU, Trondheim, Norway;Department of Anesthesia and Intensive Care Medicine, Humanitas Clinical and Research Center–IRCCS, Via Alessandro Manzoni 56, 20089, Rozzano, MI, Italy;Department of Intensive Care 1K12IC, Ghent University Hospital, Ghent, Belgium;Department of Intensive Care Medicine, Dutch Poisons Information Center (DPIC), University Medical Center, University Utrecht, Utrecht, The Netherlands;Department of Intensive Care Medicine, Inselspital, Universitätsspital, University of Bern, Bern, Switzerland;Department of Intensive Care, Aarhus University Hospital, Aarhus, Denmark;Division of Cardiology, Pulmonology and Vascular Medicine, University Hospital Düsseldorf, Heinrich-Heine- University, Düsseldorf, Germany;Division of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University Innsbruck, Innsbruck, Austria;European Wellness International, ICU, Luhansk, Ukraine;Faculdade de Ciências Médicas de Lisboa (Nova Médical School), Unidade de Cuidados Intensivos Neurocríticos E Trauma. Hospital de São José, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal;Faculty of Medicine, University of Tripoli, Tripoli, Libya;Heart Center, Linkoping University Hospital, Linkoping, Sweden;ICU, St George’s University Hospital, London, UK;Intensive Care Unit General Hospital of Larissa, Larissa, Greece;Intensive Care and Perioperative Medicine Division, Jagiellonian University Medical College, Kraków, Poland;Mater Misericordiae University Hospital, Dublin, Ireland;Research Lead Critical Care Directorate St George’s Hospital, London, UK;Sorbonne Université, INSERM, Institut Pierre Louis D’Epidémiologie Et de Santé Publique, Saint Antoine Hospital, AP-HP, Hôpital Saint-Antoine, Service de Réanimation, 75012, Paris, France;

关键词: Clinical frailty scale;    Inter-rater variability;    Intensive care;    Octogenarians;   

DOI  :  10.1186/s13613-021-00815-7

来源: Springer

【 摘 要 】

PurposeFrailty is a valuable predictor for outcome in elderly ICU patients, and has been suggested to be used in various decision-making processes prior to and during an ICU admission. There are many instruments developed to assess frailty, but few of them can be used in emergency situations. In this setting the clinical frailty scale (CFS) is frequently used. The present study is a sub-study within a larger outcome study of elderly ICU patients in Europe (the VIP-2 study) in order to document the reliability of the CFS.Materials and methodsFrom the VIP-2 study, 129 ICUs in 20 countries participated in this sub-study. The patients were acute admissions ≥ 80 years of age and frailty was assessed at admission by two independent observers using the CFS. Information was obtained from the patient, if not feasible, from the family/caregivers or from hospital files. The profession of the rater and source of data were recorded along with the score. Interrater variability was calculated using linear weighted kappa analysis.Results1923 pairs of assessors were included and background data of patients were similar to the whole cohort (n = 3920). We found a very high inter-rater agreement (weighted kappa 0.86), also in subgroup analyses. The agreement when comparing information from family or hospital records was better than using only direct patient information, and pairs of raters from same profession performed better than from different professions.ConclusionsOverall, we documented a high reliability using CFS in this setting. This frailty score could be used more frequently in elderly ICU patients in order to create a more holistic and realistic impression of the patient´s condition prior to ICU admission.

【 授权许可】

CC BY