ArticleAnnals of intensive care2023
The Clinical Frailty Scale for mortality prediction of old acutely admitted intensive care patients: a meta-analysis of individual patient-level data.
Article in Annals of intensive care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 52 papers, 1 of them a synthesis that pooled 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.
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.
Analysis of Peripheral Muscle Strength Measurement Methods in Healthy Individuals and Critical Patients: A Health Technology Assessment
Assessing the Relationship Between Frailty and Skeletal Muscle Thickness in Critically Ill Patients: A Prospective Observational Study.
Who cites it
52 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The intensive care medicine research agenda for the management of ICU acquired weakness: a multinational, interprofessional perspective.Intensive care medicine · 2025Pooled it
- Mortality Predictions Including Pre-Admission Functional Status in ICU Patients With Delirium-A Substudy of the AID-ICU Trial.Acta anaesthesiologica Scandinavica · 2026Trial
- Sublingual microcirculatory assessment on admission independently predicts the outcome of old intensive care patients suffering from shock.Scientific reports · 2024Trial
- Factors Associated with Invasive Mechanical Ventilation Requirement in Older ICU Patients: The Roles of Frailty, Comorbidity, and Acute Illness Severity.Biomedicines · 2026Article
- Integrating frailty and acute illness severity scoring for risk stratification in acute geriatric care: Review and practical guide.World journal of critical care medicine · 2026Review
- Clinical Frailty in Intensive Care Units: Prevalence and Associated Factors.Nursing in critical care · 2026Observational
- Creation of a dedicated post-intensive care geriatric unit (PIGU), proof of concept and preliminary results.European geriatric medicine · 2026Article
- In-hospital development of new-onset frailty and discharge outcomes among patients with sepsis: a Korean multicenter registry study.Journal of intensive care · 2026Article
- Simulation study of frailty as a baseline confounder: the need to improve reporting intensive care trials.Critical care (London, England) · 2026Review
- The application value of frailty assessment tools in the perioperative period: A narrative review.Journal of anesthesia and translational medicine · 2026Review
- A simplified clinical frailty scale predicts mortality in emergency department patients with acute dyspnea.GeroScience · 2026Article
- Age-related differences and common pathways of lymphocyte subsets in sepsis: a comparative review of elderly and pediatric patients.Cell death & disease · 2026Review
- Predicting weaning failure in critically ill older patients: secondary analysis of a national multicenter prospective cohort in Türkiye.BMC geriatrics · 2026Observational
- The clinical frailty scale score in older persons (≥ 65 years) admitted via the emergency department: a prospective cohort study.BMC geriatrics · 2026Article
- Unravelling the complexities of end-of-life critical care interventions: what drives medico-legal complaints to physicians?BMC health services research · 2026Article
- High blood pressure-targeted management associated with reduced benefits of higher body mass index in elderly patients with septic shock: a post hoc analysis of a multicenter randomized controlled trial.Annals of intensive care · 2026Article
- Three-year functional, physical, and mental health outcomes after critical COVID-19: A prospective multicentre cohort study.PloS one · 2026Article
- Long-term frailty trajectory in older ICU survivors requiring mechanical ventilation: a prospective cohort study in Norway.Annals of intensive care · 2026Article
- The FRAIL scale independently predicts 28-day mortality in critically ill older adults: a prospective comparison with the Clinical Frailty Scale.Frontiers in medicine · 2026Article
- Frailty in Critically Ill Cancer Patients in a Lower-middle Income Country-Prevalence, Risk Factors, and Impact on Acute Clinical Outcomes and Postdischarge Health-related Quality of Life: A Single Center Study.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
29 authors.
Funding
Abstract
backgroundThis large-scale analysis pools individual data about the Clinical Frailty Scale (CFS) to predict outcome in the intensive care unit (ICU).
methodsA systematic search identified all clinical trials that used the CFS in the ICU (PubMed searched until 24th June 2020). All patients who were electively admitted were excluded. The primary outcome was ICU mortality. Regression models were estimated on the complete data set, and for missing data, multiple imputations were utilised. Cox models were adjusted for age, sex, and illness acuity score (SOFA, SAPS II or APACHE II).
results12 studies from 30 countries with anonymised individualised patient data were included (n = 23,989 patients). In the univariate analysis for all patients, being frail (CFS ≥ 5) was associated with an increased risk of ICU mortality, but not after adjustment. In older patients (≥ 65 years) there was an independent association with ICU mortality both in the complete case analysis (HR 1.34 (95% CI 1.25-1.44), p < 0.0001) and in the multiple imputation analysis (HR 1.35 (95% CI 1.26-1.45), p < 0.0001, adjusted for SOFA). In older patients, being vulnerable (CFS 4) alone did not significantly differ from being frail. After adjustment, a CFS of 4-5, 6, and ≥ 7 was associated with a significantly worse outcome compared to CFS of 1-3.
conclusionsBeing frail is associated with a significantly increased risk for ICU mortality in older patients, while being vulnerable alone did not significantly differ. New Frailty categories might reflect its "continuum" better and predict ICU outcome more accurately.
trial registrationOpen Science Framework (OSF: https://osf.io/8buwk/ ).
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.