Validity of the FRAIL-España scale for critically ill patients.

Abstract

Objective: To evaluate the validity and sensitivity to change of the FRAIL-España scale in critically ill adult patients admitted to intensive care units (ICUs) in Spain.

Design: Descriptive, observational, prospective, multicenter, metric in nature.

Setting: ICUs in Spain.

Patients: Patients >18 years old with ICU stay >48 h.

Interventions: None.

Main variables of interest: Frailty (FRAIL-España), sociodemographic characteristics, dependency, ICU stay clinical variables, stay, mortality, destination at discharge.

Results: The prevalence of frailty at ICU admission, among the 493 patients in the cohort, was 23.9%. Multivariate risk factors for frailty were age and hospital admissions in the year prior to the current admission. Being independent, having a stable partner, and good physical quality of life are protective factors for frailty. Frailty is associated with greater resource utilization, increased mortality, and a higher likelihood of discharge to a long-stay facility. The effect size of the observed change was moderate-large (d = 0.850).

Conclusions: The FRAIL-España model shows good convergent validity with age, dependency, marital status, comorbidities, perceived physical quality of life, and hospitalization in an acute care facility in the previous year. It has good predictive validity for ICU-acquired weakness, alterations in glycemic control and resource use, hospital discharge, and mortality. It is sensitive for detecting changes in frailty.