Respiratory failure & ventilation
The Association Between Frailty, Pao 2/Fio 2 Ratio, and Hospital Mortality: A Retrospective Registry-Based Cohort Study
Authors' conclusion
This multicenter, retrospective study that investigated the association between frailty, AHRF, and in-hospital mortality found that AHRF was highly prevalent in patients with frailty. Increasing frailty was associated with higher in-hospital mortality in AHRF and its increasing severity, with a nonlinear relationship.
Study context
- Population
- Adult (≥16 yr) ICU patients with an arterial blood gas within the first 24 h, 191 ICUs, Australia New Zealand Intensive Care Society Adult Patient Database, January 2017–March 2023
- Participants
- 497,185 participants · 191 ICUs
- Exposure
- Frailty vs no frailty, across PaO2/FiO2 categories
- Frailtyn = 97,317
- Outcome
- In-hospital mortality
Methodological detailsmulticentre, registry-based, Predefined subgroup analyses by age (<65 vs ≥65 yr), mechanical ventilation status, and ICU survivors, Risk-adjusted mortality modelled with restricted cubic splines (four knots)
- Multicentre
- Registry-based
- Predefined subgroup analyses by age (<65 vs ≥65 yr), mechanical ventilation status, and ICU survivors
- Risk-adjusted mortality modelled with restricted cubic splines (four knots)
Main finding
As reported in the abstract
Overall in-hospital mortality
7.4%
36,791/497,185
A higher proportion of those who died were frail
16.4% vs. 5.2%
Observational data: associations, not effects.
Further findings
Prevalence of AHRF
Original publication
The Association Between Frailty, Pao 2/Fio 2 Ratio, and Hospital Mortality: A Retrospective Registry-Based Cohort Study. Crit Care Med. Published 21 October 2025. doi:10.
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