Prevalence of frailty and its association with six-month mortality in critically ill COVID-19 patients: a prospective observational cohort study

Background The aim of this study was to determine the prevalence of frailty using the Clinical Frailty Scale (CFS) in patients admitted to a tertiary intensive care unit (ICU) due to COVID-19 and to evaluate the association between this score and long-term mortality. Methods This single-center, prospective, observational cohort study was conducted at Selçuk University Faculty of Medicine Hospital between January 1 and June 4, 2022, and included 137 patients admitted to the intensive care unit (ICU) with COVID-19. CFS, SOFA and APACHE II scores were evaluated along with demographic, clinical, laboratory and mortality data of the patients. Risk factors associated with six-month mortality were analyzed using multivariate logistic regression. The prognostic performance of the CFS was determined via Receiver Operating Characteristic (ROC) curve analysis. Results The prevalence of clinical frailty was found to be 57.7%. The six-month mortality rate was 68.6%. CFS, SOFA, and APACHE II scores were significantly associated with six-month mortality ( p  < 0.001). The AUC value of the CFS in predicting six-month mortality was 0.765, and the optimal cut-off value was identified as 4.5. In addition, albumin, lymphocyte, and platelet levels were higher in survivors, whereas ferritin, CRP/albumin ratio, and procalcitonin levels were found to be higher in non-survivors. Conclusions Clinical Frailty Score is an independent risk factor for predicting long-term mortality in patients with COVID-19.. CFS is a valuable prognostic tool that can be used in addition to classical scoring systems for patient management and resource planning in intensive care units. Trial registration: ClinicalTrials.gov identifier: NCT06330883