Evidence map›Paper›PMID 35339999›Full record

SynthesisGerontology2022

Methods of Assessing Frailty in the Critically Ill: A Systematic Review of the Current Literature.

Daniela Bertschi, Jan Waskowski, Manuel Schilling, Claudia Donatsch, Joerg Christian Schefold, Carmen Andrea Pfortmueller

Open access · hybridAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Gerontology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 1 pooled it
4.3field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.

  1. Pooled it
  2. Observational
  3. Review
  4. Impact of Frailty (Clinical Frailty Scale) on Weaning from Mechanical Ventilation: A Systematic Review and Meta-analysis.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2026
    Article
  5. Article
  6. Article
  7. Review
  8. Article
  9. Sarcopenia and frailty in critical illness.Current opinion in clinical nutrition and metabolic care · 2025
    Review
  10. Observational
  11. Article
  12. Article
  13. Article
  14. Article
  15. Review
  16. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 2 countries.

Daniela BertschiDepartment of Intensive Care, Inselspital Bern University Hospital and University of Bern, Bern, Switzerland.
Jan WaskowskiDepartment of Intensive Care, Inselspital Bern University Hospital and University of Bern, Bern, Switzerland.
Manuel SchillingDepartment of Intensive Care, Inselspital Bern University Hospital and University of Bern, Bern, Switzerland.
Claudia DonatschDeutsches Herzzentrum Berlin, Berlin, Germany.
Joerg Christian SchefoldDepartment of Intensive Care, Inselspital Bern University Hospital and University of Bern, Bern, Switzerland.
Carmen Andrea PfortmuellerDepartment of Intensive Care, Inselspital Bern University Hospital and University of Bern, Bern, Switzerland.
University of Bern · CHDeutsches Herzzentrum der Charité · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAs new treatments have become established, more frail pre-ICU patients are being admitted to intensive care units (ICUs); this is creating new challenges to provide adequate care and to ensure that resources are allocated in an ethical and economical manner. This systematic review evaluates the current standard for assessing frailty on the ICU, including methods of assessment, time point of measurements, and cut-offs.

methodsA systematic search was conducted on MEDLINE, Clinical Trials, Cochrane Library, and Embase. Randomized and non-randomized controlled studies were included that evaluated diagnostic tools and ICU outcomes for frailty. Exclusion criteria were the following: studies without baseline assessment of frailty on ICU admission, studies in paediatric patients or pregnant women, and studies that targeted very narrow populations of ICU patients. Eligible articles were included until January 31, 2021. Methodological quality was assessed using the Newcastle-Ottawa Scale. No meta-analysis was performed, due to heterogeneity.

resultsN = 57 articles (253,376 patients) were included using 19 different methods to assess frailty or a surrogate. Frailty on ICU admission was most frequently detected using the Clinical Frailty Scale (CFS) (n = 35, 60.3%), the Frailty Index (n = 5, 8.6%), and Fried's frailty phenotype (n = 6, 10.3%). N = 22 (37.9%) studies assessed functional status. Cut-offs, time points, and manner of baseline assessment of frailty on ICU admission varied widely. Frailty on ICU admission was associated with short- and long-term mortality, functional and cognitive impairment, increased health care dependency, and impaired quality of life post-ICU discharge.

conclusionsFrailty assessment on the ICU is heterogeneous with respect to methods, cut-offs, and time points. The CFS may best reflect frailty in the ICU. Frailty assessments should be harmonized and performed routinely in the critically ill.

Indexed as

FrailtyCritical IllnessFemaleHumansIntensive Care UnitsPregnancyQuality of LifeAssessmentCritical careDecision-makingFrailtyGeriatric medicineOutcome

Identifiers

PMID35339999
PMCPMC9808663
OpenAlexW4220850165

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.