Frailty, Outcomes, Recovery and Care Steps of Critically Ill Patients (FORECAST): a prospective, multi-centre, cohort study
Authors' conclusion
Frailty severity was dynamic, can be measured during recovery from critical illness using the CFS and FI which were both associated with worse outcomes.
Study context
- Population
- Patients ≥ 50 years old receiving life support > 24 h
- Participants
- 687 patients
- Exposure
- Frailty measured by Clinical Frailty Scale (CFS) vs Frailty Index (FI)
- Outcome
- Frailty prevalence (CFS ≥ 5 or FI ≥ 0.2)
- Follow-up
- ICU admission, hospital discharge and 6 months
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
Frailty prevalence
- Intensive care unit (ICU) admission, CFS
- 29.8%
- ICU admission, FI
- 44.8%
- Hospital discharge, CFS
- 54.6%
- Hospital discharge, FI
- 67.9%
- 6 months, CFS
- 34.1%
- 6 months, FI
- 42.6%
Observational data: associations, not effects.
Further findings
Frailty trajectory · 6 months
- CFS higher at 6 months vs ICU admission
- 45.3%
- FI higher at 6 months vs ICU admission
- 50.6%
- CFS higher at 6 months vs hospital discharge
- 18.7%
- FI higher at 6 months vs hospital discharge
- 20%
- Aggregate frailty severity increased from ICU admission to hospital discharge but improved by 6 months
Mortality
- Higher in frail patients
Processes of care
- Similar except worse ICU/ward mobility in frail patients
Safety
Adverse events
- Similar except more frequent delirium in frail patients
Original publication
Frailty, Outcomes, Recovery and Care Steps of Critically Ill Patients (FORECAST): a prospective, multi-centre, cohort study. Intensive Care Med. Published 15 May 2024. doi:10.
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