Frailty in intensive care medicine must be measured, interpreted and taken into account!

Excerpt

Frailty has become a condition we as intensivists have been gradually more familiar with. Geriatricians have developed the concept and it includes several age-related changes leading to the hallmarks of frailty: slow walking speed, impaired grip strength, low activity, unintended weight loss, and exhaustion [1]. An early paper about frailty in the intensive care unit (ICU) context was published in 2014 [2] and frailty has since attained considerable attraction and has been found to be closely related to an adverse outcome after ICU admissions [3]. This is most pronounced in the very old ICU patient where it is an independent risk factor for short-term mortality [4]. Frailty not only affects mortality outcomes but has been found to prolong ICU and hospital stay with increased use of organ support [3] as well as a poor quality of life post-hospital discharge [5]. More patients with frailty developed persistent critical illness than patients with no frailty in a recent large cohort study from Australia and New Zealand [6], a condition that affect around 8–10% of ICU survivors. It is also important to acknowledge that frailty is not operating isolated, but is closely associated with other geriatric syndromes as activity of daily life, cognition and multimorbidity [7]. …