ArticleCritical care explorations2022
Association of Frailty, Organ Support, and Long-Term Survival in Critically Ill Patients With COVID-19.
Article in Critical care explorations, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Article
- Proposed intensive care unit triage models lack predictive validity for hospital mortality to deal with catastrophes: insights from a cohort study.Critical care science · 2026Article
- Discordance between physical and cognitive health problems over one year after critical care: Insights from severe COVID-19 patients.The journal of nutrition, health & aging · 2025Article
- Prevalence of New Frailty at Hospital Discharge in Severe COVID-19 Survivors and Its Associated Factors.Tuberculosis and respiratory diseases · 2025Article
- Impact of frailty on long-term survival in patients discharged alive from hospital after an ICU admission with COVID-19.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2024Article
- Frailty in Critically Ill Patients with COVID-19: The Lessons Learned.Advances in experimental medicine and biology · 2024Review
- The impact of body mass index on long-term survival after ICU admission due to COVID-19: A retrospective multicentre study.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2023Article
- Prevalence of physical frailty, including risk factors, up to 1 year after hospitalisation for COVID-19 in the UK: a multicentre, longitudinal cohort study.EClinicalMedicine · 2023Article
- Twelve Months and Counting: Following Clinical Outcomes in Critical COVID-19 Survivors.Annals of the American Thoracic Society · 2023Article
- Review
- Calculating Route: Functional Trajectories and Long-Term Outcomes in Survivors of Severe COVID-19.The journal of nutrition, health & aging · 2023Article
- Tailoring treatments to older people in intensive care. A way forward.Intensive care medicine · 2022Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Few studies have explored the effect of frailty on the long-term survival of COVID-19 patients after ICU admission. Furthermore, the Clinical Frailty Scale (CFS) validity in critical care patients remains debated. We investigated the association between frailty and 6-month survival in critically ill COVID-19 patients. We also explored whether ICU resource utilization varied according to frailty status and examined the concurrent validity of the CFS in this setting.
designAncillary study of a longitudinal prospective cohort.
settingUniversity hospital in São Paulo. PATIENTS: Patients with severe COVID-19 admitted to ICU.
interventionsNone. MEASUREMENTS AND MAIN
resultsWe assessed baseline frailty using the CFS (1-9; frail ≥ 5) and used validated procedures to compute a Frailty Index (0-1; frail > 0.25). We used Cox models to estimate associations of frailty status with 6-month survival after ICU admission and area under the receiver operating characteristic curves (AUCs) to estimate CFS's accuracy in identifying frailty according to Frailty Index. We included 1,028 patients (mean age, 66 yr; male, 61%). Overall, 224 (22%) patients were frail (CFS ≥ 5), and 608 (59%) died over the 6-month follow-up. Frailty was independently associated with lower 6-month survival and further stratified mortality in patients with similar age and Sequential Organ Failure Assessment scores. We additionally verified that the CFS was highly accurate in identifying frailty as defined by the Frailty Index (AUC, 0.91; 95% CI, 0.89-0.93). Although treatment modalities did not diverge according to frailty status, higher CFS scores were associated with withholding organ support due to refractory organ failure.
conclusionsOne in five COVID-19 patients admitted to the ICU was frail. CFS scores greater than or equal to 5 were associated with lower long-term survival and decisions on withholding further escalation of invasive support for multiple organ failure in the ICU. Clinicians should consider frailty alongside sociodemographic and clinical measures to have a fuller picture of COVID-19 prognosis in critical care.
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