Effect of pre-morbid frailty status on in hospital mortality in critically ill patients.

Abstract

Objective: To determine the pre-morbid frailty and its association with in-hospital mortality among critically ill patients admitted in intensive care unit (ICU) of a tertiary care hospital. Study Design: Cross-sectional study. Setting: ICU of Sindh Institute of Urology and Transplantation, Karachi, Pakistan. Period: December 2022 to July 2023. Material & Methods: Patients of age 18 years or older, admitted to the ICU were included. Frailty was defined as per Clinical Frailty Scale (CFS). Detailed history was taken to assess frailty status two weeks prior to hospital admission. Patients were classified as pre-morbid frail if their score was higher than 4. Results: Total 151 patients were analyzed with median age of 47 (IQR= 33-59) years. There were 106 (70.2%) male patients, whereas and 92 (60.9%) were having comorbidities. Median CFS score was 4 (IQR=3-5). Out of 151 patients admitted to ICU, 56 (37.1%) had frail. Odds of frailty were increasing with increasing age and among those who had comorbidity. Mechanical ventilation (MV) days (p=0.234), hemodynamic support days (p=0.216) and LOS (p=0.903) were not significantly different among frail and non-frail patients. Nearly half of the patients had died (49%). Mortality was noted in 74 (49.0%) patients. Need of MV, hemodynamic support, APACHEII and SOFA score were associated with mortality (p<0.05). Conclusion: There was considerable burden of frailty among critically ill patients admitted in ICU. However, in-hospital outcomes including mechanical ventilation, hemodynamic support and mortality were not associated with frailty status.