A critical age: can we reliably measure frailty in critical care?

Excerpt

As populations age, the proportion of older patients admitted to critical care units has risen in a number of nations [1]. Age remains an independent predictor of poorer short- and long- term outcomes following critical care admission [1], but the distinction between “physiological” and “chronological” age has long been apparent to critical care clinicians. For the critically ill, assessment of frailty (“a condition characterised by loss of biological reserve and vulnerability to poor resolution of homeostasis following a stressor event” [2]) offers the potential both to inform discussions when escalation of care is being considered, and to identify those who may need a higher level of support in their recovery from critical illness. Although several reports regarding the predictive validity of frailty assessment tools in the critically ill have been published recently [3], study of the reliability of such assessments is virtually absent from the critical care literature. …