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

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

DOI

  • Hans Flaatten, Department of Biology, University of Bergen, Bergen, Norway; Sars International Centre, Uni Research, University of Bergen, Bergen, Norway.
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  • Bertrand Guidet, Hospital Saint-Antoine, Paris, France., Sorbonne Université
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  • Finn H Andersen, Department of Oncology, Ålesund Hospital, Ålesund, Norway., NTNU
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  • Antonio Artigas, Autonomous Univ Barcelona, Autonomous University of Barcelona, University of Barcelona, Corporac Sanitaria Univ Parc Tauli, Dept Intens Care Medecine, CIBER Enfermedades Respiratorias
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  • Maurizio Cecconi, IRCCS, Humanitas Clinical and Research Center, Milan, Italy.
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  • Ariane Boumendil, Hôpital Saint-Antoine
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  • Muhammed Elhadi, Zoology Department, Faculty of Sciences, The University of Tripoli, P.O. Box 13227, Tripoli, Libya
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  • Jesper Fjølner
  • Michael Joannidis, Univ Klin Innsbruck, Medical University of Innsbruck
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  • Christian Jung, Heinrich Heine Univ Dusseldorf, Heinrich Heine University Dusseldorf, Heinrich Heine University Dusseldorf Hospital, Univ Hosp Dusseldorf, Dept Gynaecol & Obstet
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  • Susannah Leaver, Research Lead Critical Care Directorate St George's Hospital
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  • Brian Marsh, Mater Misericordiae University Hospital
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  • Rui Moreno, Lisbon Institute of Global Mental Health and Chronic Diseases Research Center (CEDOC), NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal.
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  • Sandra Oeyen, Ghent Univ Hosp, Ghent University Hospital, Ghent University, Dept Rheumatol
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  • Yuriy Nalapko, European Wellness International
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  • Joerg C Schefold, Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; and.
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  • Wojciech Szczeklik, Jagiellonian University Medical College
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  • Sten Walther, Linkoping University Hospital, 581 85, Linkoping, Sweden.
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  • Ximena Watson, St George's Vascular Institute, St George's University Hospital, London
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  • Tilemachos Zafeiridis, Intensive Care Unit General Hospital of Larissa, Larissa, Greece.
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  • Dylan W de Lange, Univ Utrecht, Utrecht University Medical Center, Utrecht University, Univ Med Ctr Utrecht, Regenerat Med Ctr
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  • VIP2 Study Group
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.
Bidragets oversatte titelReliabilitet af Clinical Frailty Scale hos gamle intensivpatienter: et prospektivt europæisk studie
OriginalsprogEngelsk
Artikelnummer22
TidsskriftAnnals of Intensive Care
Vol/bind11
ISSN2110-5820
DOI
StatusUdgivet - feb. 2021

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