The FRAIL scale independently predicts 28-day mortality in critically ill older adults: a prospective comparison with the Clinical Frailty Scale.

Background: Frailty is a multidimensional syndrome associated with adverse outcomes in older adults. This study aimed to compare the predictive value of the FRAIL scale and the Clinical Frailty Scale (CFS) for 28-day mortality among critically ill geriatric patients. Methods: In this prospective cohort study conducted in a tertiary intensive care unit, all consecutive patients aged ≥65 years were assessed for frailty at intensive care unit admission using the FRAIL scale and the CFS. Logistic regression analysis was performed to identify independent associations with 28-day mortality. Receiver operating characteristic analyses with DeLong comparison and Kaplan-Meier survival analyses with log-rank testing were also performed. Results: Among 168 patients, 53% were male, and the median age was 77 years (IQR 70-82). The 28-day mortality rate was significantly higher in frail patients compared with non-frail patients according to both the FRAIL scale (36% vs. 16%, Conclusion: Frailty at ICU admission is an important predictor of short-term mortality in older adults. The FRAIL scale demonstrated independent prognostic value in the primary adjusted model, while AUROC comparison did not show a statistically significant discrimination advantage over the CFS.