Methods of Assessing Frailty in the Critically Ill: A Systematic Review of the Current Literature.

Bertschi, Daniela; Waskowski, Jan; Schilling, Manuel; Donatsch, Claudia; Schefold, Joerg Christian; Pfortmueller, Carmen Andrea (2022). Methods of Assessing Frailty in the Critically Ill: A Systematic Review of the Current Literature. Gerontology, 68(12), pp. 1321-1349. Karger 10.1159/000523674

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As new treatments have become established, more frail pre-ICU patients are being admitted to intensive care units (ICUs); this is creating new challenges to provide adequate care and to ensure that resources are allocated in an ethical and economical manner. This systematic review evaluates the current standard for assessing frailty on the ICU, including methods of assessment, time point of measurements, and cut-offs.


A systematic search was conducted on MEDLINE, Clinical Trials, Cochrane Library, and Embase. Randomized and non-randomized controlled studies were included that evaluated diagnostic tools and ICU outcomes for frailty. Exclusion criteria were the following: studies without baseline assessment of frailty on ICU admission, studies in paediatric patients or pregnant women, and studies that targeted very narrow populations of ICU patients. Eligible articles were included until January 31, 2021. Methodological quality was assessed using the Newcastle-Ottawa Scale. No meta-analysis was performed, due to heterogeneity.


N = 57 articles (253,376 patients) were included using 19 different methods to assess frailty or a surrogate. Frailty on ICU admission was most frequently detected using the Clinical Frailty Scale (CFS) (n = 35, 60.3%), the Frailty Index (n = 5, 8.6%), and Fried's frailty phenotype (n = 6, 10.3%). N = 22 (37.9%) studies assessed functional status. Cut-offs, time points, and manner of baseline assessment of frailty on ICU admission varied widely. Frailty on ICU admission was associated with short- and long-term mortality, functional and cognitive impairment, increased health care dependency, and impaired quality of life post-ICU discharge.


Frailty assessment on the ICU is heterogeneous with respect to methods, cut-offs, and time points. The CFS may best reflect frailty in the ICU. Frailty assessments should be harmonized and performed routinely in the critically ill.

Item Type:

Journal Article (Review Article)


04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care

UniBE Contributor:

Bertschi, Daniela, Waskowski, Jan, Schilling, Manuel, Schefold, Jörg Christian, Pfortmüller, Carmen


600 Technology > 610 Medicine & health








Pubmed Import

Date Deposited:

29 Mar 2022 09:44

Last Modified:

05 Dec 2022 16:17

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Uncontrolled Keywords:

Assessment Critical care Decision-making Frailty Geriatric medicine Outcome




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