Frailty, Outcomes, Recovery and Care Steps of Critically Ill Patients (FORECAST) Study Multi-Center Study

Frailty is common in critically ill elderly patients, and is associated with adverse impacts on outcomes and is becoming increasingly common in Intensive Care Unit (ICU) populations. However it is not clear as to how to best measure frailty and when to do so. It is also not clear as to how processes of care impact on the outcomes observed. We hypothesize that frailty in survivors of critical illness will be measurable at hospital discharge, will correlate with processes of care while in ICU and will better discriminate long term outcomes when compared to severity of illness or the degree of frailty present on ICU admission.

Inclusion criteria

Must Meet both 1 and 2

• 1. Age > 50 years. We have selected >50 years in keeping with prior descriptions of critically ill patients [17].

• Receipt of at least one of the following life support interventions for over 24 hours:
• Mechanical ventilation: Both invasive and non-invasive either solely or in combination are acceptable. High flow oxygen (e.g. OPTIFLOW) as a form of Non-Invasive Ventilation (NIV) is acceptable but the patient's Fraction of Inspired Oxygen (FIO2) at the time of enrollment must be greater > 50%.
• Vasoactive medications (vasopressors or inotropes).
• Acute renal replacement therapy (RRT). Patient must have been admitted to ICU for the receipt of renal replacement therapy, either intermittent or continuous and after 24 hours of ICU admission, there is a continued need for further RRT.

Exclusion criteria

• ICU admission greater than 5 days at the time of enrollment.
• Expected to survive for less than 72 hours after study enrollment.
• No family or caregivers available to collect collateral history.
• Family or caregivers not able to speak English or French.
• Projected inability to complete 6 month follow-up either by telephone or in-person.