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Clinical Frailty Scale and Frailty Index in Predicting Long-Term Survival for the Critically Ill: a review

Frailty is a state of vulnerability, recognised clinically, where patients experience an ageing-associated decline in their physical and cognitive abilities. There are two main scales for measuring frailty. The Clinical Frailty Scale (CFS) is often used for intensive care unit patients. The Diseases-10 Modified Frailty Index (mFI) is also used; it is derived from the understanding of 11 comorbidities. However, it was unknown how the two compare. In this study of 7,001 patients, it was found that a greater proportion of patients were categorised as frail using the CFS, and this scale also predicted better those who would survive past the 6-month mark versus those who would die. This indicates that the two scales are not equivalent, and the mFI should not be used for frailty. This review by A. Subramaniam et al. aimed to highlight the differences between the two scales, the Clinical Frailty Scale and the Diseases-10 Modified Frailty Index, to determine which is a better predictor of frailty.

Article: Comparing the Clinical Frailty Scale and an International Classification of Diseases-10 Modified Frailty Index in Predicting Long-Term Survival in Critically Ill Patients

Frailty is a state of vulnerability, recognised clinically, where patients experience an ageing-associated decline in their physical and cognitive abilities. There are two main scales for measuring frailty. The Clinical Frailty Scale (CFS) is often used for intensive care unit patients. The Diseases-10 Modified Frailty Index (mFI) is also used; it is derived from the understanding of 11 comorbidities. However, it was unknown how the two compare. In this study of 7,001 patients, it was found that a greater proportion of patients were categorised as frail using the CFS, and this scale also predicted better those who would survive past the 6-month mark versus those who would die. This indicates that the two scales are not equivalent, and the mFI should not be used for frailty.

This review by A. Subramaniam et al. aimed to highlight the differences between the two scales, the Clinical Frailty Scale and the Diseases-10 Modified Frailty Index, to determine which is a better predictor of frailty.

Key learnings Although the Diseases-10 Modified Frailty Index may be useful for understanding comorbidities and other clinical factors, it appears, according to this study, that it is not a useful index for frailty and that the Clinical Frailty Scale should be used.

Reviewed by: Z. Beketova

Authors: A. Subramaniam; R. Ueno; R. Tiruvoipati, et al.

Published in: Crit Care Explor (October 2022)

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