Fiabilidad intraobservador e interobservador de las escalas de fragilidad Clinical Frailty Scale-España y FRAIL-España en pacientes críticos

IF 2.7 4区医学 Q2 CRITICAL CARE MEDICINE

Medicina Intensiva Pub Date : 2025-07-01 DOI:10.1016/j.medin.2024.502131

Susana Arias-Rivera , María Mar Sánchez-Sánchez , Raquel Jareño-Collado , Marta Raurell-Torredà , Lorena Oteiza-López , Sonia López-Cuenca , Israel John Thuissard-Vasallo , Fernando Frutos-Vivar

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引用次数: 0

Abstract

Objective

To evaluate the intrarater and interrater reliability of the Clinical Frailty Scale-Spain (CFS-España) and FRAIL-España and the internal consistency of the FRAIL-España when implemented in critically ill patients by intensive care nurses and physicians.

Design

Descriptive, observational and metric study.

Setting

Intensive care unit (ICU) of Spain.

Patients

Patients > 18 years, with > 48 UCI hours.

Intervention

None.

Main variables of interest

On admission, frailty with CFS-España and FRAIL-España (by 3 nurses and 2 intensive care physicians), sex, age, comorbidities and severity.

Results

1,045 assessments were performed in 206 patients. Not frail patients on admission: 53% according to the CFS-Spain and 34% according to the FRAIL-Spain.

The intraclass correlation coefficient (ICC) shows almost perfect intrarater concordance (> 0.80 for CFS-España and > 0.90 for FRAIL-España). Agreement by frailty strata (non-fragile, pre-fragile and fragile patients) was substantial or almost perfect, with no major differences in ratings between nurses and physicians.

Interprofessional concordance shows an almost perfect ICC for both scales. The lowest agreement was obtained for the FRAIL-España ratings among physicians. In the frailty strata analysis, agreement was moderate. The highest agreement for the CFS-España was considering level 4 patients as frail.

High reliability of the FRAIL-España and strong correlation of all dimensions with the global assessment were obtained, except for the comorbidities dimension, with a weak correlation.

Conclusion

The CFS-España and FRAIL-España scales are reliable for assessing frailty in critically ill patients by nurses and/or intensive care physicians.

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重症患者临床虚弱量表（西班牙）和FRAIL（西班牙）的观察内和观察间可靠性

目的评价西班牙临床虚弱量表（CFS-España）和FRAIL-España在重症监护护士和内科医生实施时的内部信度和内部信度，以及FRAIL-España的内部一致性。设计描述性、观察性和度量性研究。西班牙重症监护病房（ICU）。PatientsPatients祝辞18年，与>；入院时，虚弱（CFS-España和FRAIL-España）（3名护士和2名重症监护医生），性别，年龄，合并症和严重程度。结果206例患者共进行1045次评估。入院时身体不虚弱的患者：根据CFS-Spain的数据为53%，根据fail - spain的数据为34%。类内相关系数（ICC）显示出几乎完美的类内一致性(>；0.80 CFS-España和>；0.90 （FRAIL-España）。脆弱阶层（非脆弱、预脆弱和脆弱患者）的同意是实质性的或几乎完美的，护士和医生之间的评分没有重大差异。专业间的一致性表明，这两个尺度的ICC几乎是完美的。在医生中，FRAIL-España评分的一致性最低。在脆弱层分析中，一致性是中等的。CFS-España的最高协议是将4级患者视为虚弱。除了合并症维度外，FRAIL-España的可靠性高，所有维度与整体评估的相关性强，相关性弱。结论CFS-España和FRAIL-España量表是护士和（或）重症监护医师评估危重病人虚弱程度的可靠量表。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medicina Intensiva CRITICAL CARE MEDICINE-

CiteScore

2.70

自引率

20.00%

发文量

146

审稿时长

33 days

期刊介绍： Medicina Intensiva is the journal of the Spanish Society of Intensive Care Medicine and Coronary Units (SEMICYUC) and of Pan American and Iberian Federation of Societies of Intensive and Critical Care Medicine. Medicina Intensiva has become the reference publication in Spanish in its field. The journal mainly publishes Original Articles, Reviews, Clinical Notes, Consensus Documents, Images, and other information relevant to the specialty. All works go through a rigorous selection process. The journal accepts submissions of articles in English and in Spanish languages. The journal follows the publication requirements of the International Committee of Medical Journal Editors (ICMJE) and the Committee on Publication Ethics (COPE).