Perioperative medicine & outcomes
Does the Frailty Burden Impact ICU Performance Indicators Benchmarking? A Multicenter Cohort Study Using Two Severity-of-Illness Scores
Authors' conclusion
Frailty burden had no significant impact on ICU benchmarking with SAPS 3 or MPM 0-III , suggesting limited relevance for performance comparisons.
Study context
- Population
- Patients admitted to 159 ICUs in Brazil and Uruguay, 2022–2023; frailty = Modified Frailty Index (MFI) ≥3
- Participants
- 242,141 patients · 159 ICUs
- Exposure
- Frailty burden vs ICU performance indicators by Simplified Acute Physiology Score (SAPS) 3 and Mortality Probability Model (MPM) 0-III
- Outcome
- Spearman correlation of frailty burden with performance indicators
Methodological detailsprospectively collected data, multicentre, SAPS 3 and MPM 0-III recalibrated, standardized resource use (SRU) parameters reestimated
- Prospectively collected data
- Multicentre
- SAPS 3 and MPM 0-III recalibrated, SRU parameters reestimated
Main finding
As reported in the abstract
MPM 0-III standardized mortality rate (SMR): r
−0.123
95% CI −0.262 to 0.035
MPM 0-III SRU: r
−0.091
95% CI −0.252 to 0.081
SAPS 3 SMR: r
−0.105
95% CI −0.258 to 0.044
SAPS 3 SRU: r
−0.074
95% CI −0.236 to 0.096
Observational data: associations, not effects.
Further findings
Frailty burden and hospital mortality per ICU
- Median frailty burden, % (IQR 16.8-31.7%)
- 23.0%
- Median hospital mortality, % (IQR 9.1-25.2%)
- 14.8%
- Higher frailty burden ICUs showed greater mortality, no consistent trend
Recalibration with addition of MFI
- Did not improve estimates
Efficiency matrix
- ICUs with varying frailty burdens evenly distributed across quadrants
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
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