Reliability of frailty assessment in the critically ill: a multicentre prospective observational study

Anaesthesia
Richard J PughNazir I Lone

Abstract

Demand for critical care among older patients is increasing in many countries. Assessment of frailty may inform discussions and decision making, but acute illness and reliance on proxies for history-taking pose particular challenges in patients who are critically ill. Our aim was to investigate the inter-rater reliability of the Clinical Frailty Scale for assessing frailty in patients admitted to critical care. We conducted a prospective, multi-centre study comparing assessments of frailty by staff from medical, nursing and physiotherapy backgrounds. Each assessment was made independently by two assessors after review of clinical notes and interview with an individual who maintained close contact with the patient. Frailty was defined as a Clinical Frailty Scale rating > 4. We made 202 assessments in 101 patients (median (IQR [range]) age 69 (65-75 [60-80]) years, median (IQR [range]) Acute Physiology and Chronic Health Evaluation II score 19 (15-23 [7-33])). Fifty-two (51%) of the included patients were able to participate in the interview; 35 patients (35%) were considered frail. Linear weighted kappa was 0.74 (95%CI 0.67-0.80) indicating a good level of agreement between assessors. However, frailty rating differed by at least...Continue Reading

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Citations

Mar 13, 2019·Anaesthesia·J R Falvey, L E Ferrante
Apr 3, 2020·Intensive Care Medicine·Oliver C RedfernPeter J Watkinson
May 10, 2020·Anesthesia and Analgesia·Justin C De BiasioShahzad Shaefi
May 15, 2020·MMW Fortschritte der Medizin·Joachim ZeehAnja Kwetkat
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Nov 24, 2020·Journal of the American Medical Directors Association·André HajekHans-Helmut König
Feb 4, 2021·Annals of Intensive Care·Hans FlaattenUNKNOWN VIP2 Study Group
Jan 23, 2021·International Journal of Environmental Research and Public Health·Antonio MessinaMaurizio Cecconi
Feb 20, 2021·Age and Ageing·Olga TheouKenneth Rockwood
Sep 1, 2021·Australian Critical Care : Official Journal of the Confederation of Australian Critical Care Nurses·Yvette M LowMatthew J Maiden

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