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Reliability of the Clinical Frailty Scale in very elderly ICU patients: a prospective European study.

Flaatten, H; Guidet, B; Andersen, FH; Artigas, A; Cecconi, M; Boumendil, A; Elhadi, M; Fjølner, J; Joannidis, M; Jung, C; et al. Flaatten, H; Guidet, B; Andersen, FH; Artigas, A; Cecconi, M; Boumendil, A; Elhadi, M; Fjølner, J; Joannidis, M; Jung, C; Leaver, S; Marsh, B; Moreno, R; Oeyen, S; Nalapko, Y; Schefold, JC; Szczeklik, W; Walther, S; Watson, X; Zafeiridis, T; de Lange, DW; VIP2 Study Group (2021) Reliability of the Clinical Frailty Scale in very elderly ICU patients: a prospective European study. Ann Intensive Care, 11 (1). p. 22. ISSN 2110-5820 https://doi.org/10.1186/s13613-021-00815-7
SGUL Authors: Cecconi, Maurizio

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Abstract

PURPOSE: Frailty is a valuable predictor for outcome in elderly ICU patients, and has been suggested to be used in various decision-making processes prior to and during an ICU admission. There are many instruments developed to assess frailty, but few of them can be used in emergency situations. In this setting the clinical frailty scale (CFS) is frequently used. The present study is a sub-study within a larger outcome study of elderly ICU patients in Europe (the VIP-2 study) in order to document the reliability of the CFS. MATERIALS AND METHODS: From the VIP-2 study, 129 ICUs in 20 countries participated in this sub-study. The patients were acute admissions ≥ 80 years of age and frailty was assessed at admission by two independent observers using the CFS. Information was obtained from the patient, if not feasible, from the family/caregivers or from hospital files. The profession of the rater and source of data were recorded along with the score. Interrater variability was calculated using linear weighted kappa analysis. RESULTS: 1923 pairs of assessors were included and background data of patients were similar to the whole cohort (n = 3920). We found a very high inter-rater agreement (weighted kappa 0.86), also in subgroup analyses. The agreement when comparing information from family or hospital records was better than using only direct patient information, and pairs of raters from same profession performed better than from different professions. CONCLUSIONS: Overall, we documented a high reliability using CFS in this setting. This frailty score could be used more frequently in elderly ICU patients in order to create a more holistic and realistic impression of the patient´s condition prior to ICU admission.

Item Type: Article
Additional Information: © The Author(s) 2021. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Keywords: Clinical frailty scale, Intensive care, Inter-rater variability, Octogenarians, VIP2 Study Group, Clinical frailty scale, Inter-rater variability, Intensive care, Octogenarians
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Ann Intensive Care
ISSN: 2110-5820
Language: eng
Dates:
DateEvent
3 February 2021Published
27 January 2021Accepted
Publisher License: Creative Commons: Attribution 4.0
PubMed ID: 33534010
Web of Science ID: WOS:000614405200001
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/113034
Publisher's version: https://doi.org/10.1186/s13613-021-00815-7

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