Susana Arias-Rivera, María Mar Sánchez-Sánchez, Raquel Jareño-Collado, Marta Raurell-Torredà, Lorena Oteiza-López, Sonia López-Cuenca, Israel John Thuissard-Vasallo, Fernando Frutos-Vivar
{"title":"危重病人临床虚弱量表-Es 和 FRAIL-Es 的校内和校间可靠性。","authors":"Susana Arias-Rivera, María Mar Sánchez-Sánchez, Raquel Jareño-Collado, Marta Raurell-Torredà, Lorena Oteiza-López, Sonia López-Cuenca, Israel John Thuissard-Vasallo, Fernando Frutos-Vivar","doi":"10.1016/j.medine.2025.502131","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the intrarater and interrater reliability of the Clinical Frailty Scale-Spain (CFS-España) and FRAIL-España and the internal consistency of the FRAIL-España when implemented in critically ill patients by intensive care nurses and physicians.</p><p><strong>Design: </strong>Descriptive, observational and metric study.</p><p><strong>Setting: </strong>intensive care unit (ICU) of Spain.</p><p><strong>Patients: </strong>Patients >18 years, with >48 UCI hours.</p><p><strong>Intervention: </strong>None.</p><p><strong>Main variables of interest: </strong>On admission, frailty with CFS-España and FRAIL-España (by 3 nurses and 2 intensive care physicians), sex, age, comorbidities and severity.</p><p><strong>Results: </strong>1045 assessments were performed in 206 patients. Not frail patients on admission: 53% according to the CFS-Spain and 34% according to the FRAIL-Spain. The intraclass correlation coefficient (ICC) shows almost perfect intrarater concordance (>0.80 for CFS-España and >0.90 for FRAIL-España). Agreement by frailty strata (non-fragile, pre-fragile and fragile patients) was substantial or almost perfect, with no major differences in ratings between nurses and physicians. Interprofessional concordance shows an almost perfect ICC for both scales. The lowest agreement was obtained for the FRAIL-España ratings among physicians. In the frailty strata analysis, agreement was moderate. The highest agreement for the CFS-España was considering level 4 patients as frail. High reliability of the FRAIL-España and strong correlation of all dimensions with the global assessment were obtained, except for the comorbidities dimension, with a weak correlation.</p><p><strong>Conclusion: </strong>The CFS-España and FRAIL-España scales are reliable for assessing frailty in critically ill patients by nurses and/or intensive care physicians.</p>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502131"},"PeriodicalIF":0.0000,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Intrarater and interrater reliability of the Clinical Frailty Scale-Es and FRAIL-Es in critically ill patients.\",\"authors\":\"Susana Arias-Rivera, María Mar Sánchez-Sánchez, Raquel Jareño-Collado, Marta Raurell-Torredà, Lorena Oteiza-López, Sonia López-Cuenca, Israel John Thuissard-Vasallo, Fernando Frutos-Vivar\",\"doi\":\"10.1016/j.medine.2025.502131\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To evaluate the intrarater and interrater reliability of the Clinical Frailty Scale-Spain (CFS-España) and FRAIL-España and the internal consistency of the FRAIL-España when implemented in critically ill patients by intensive care nurses and physicians.</p><p><strong>Design: </strong>Descriptive, observational and metric study.</p><p><strong>Setting: </strong>intensive care unit (ICU) of Spain.</p><p><strong>Patients: </strong>Patients >18 years, with >48 UCI hours.</p><p><strong>Intervention: </strong>None.</p><p><strong>Main variables of interest: </strong>On admission, frailty with CFS-España and FRAIL-España (by 3 nurses and 2 intensive care physicians), sex, age, comorbidities and severity.</p><p><strong>Results: </strong>1045 assessments were performed in 206 patients. Not frail patients on admission: 53% according to the CFS-Spain and 34% according to the FRAIL-Spain. The intraclass correlation coefficient (ICC) shows almost perfect intrarater concordance (>0.80 for CFS-España and >0.90 for FRAIL-España). Agreement by frailty strata (non-fragile, pre-fragile and fragile patients) was substantial or almost perfect, with no major differences in ratings between nurses and physicians. Interprofessional concordance shows an almost perfect ICC for both scales. The lowest agreement was obtained for the FRAIL-España ratings among physicians. In the frailty strata analysis, agreement was moderate. The highest agreement for the CFS-España was considering level 4 patients as frail. High reliability of the FRAIL-España and strong correlation of all dimensions with the global assessment were obtained, except for the comorbidities dimension, with a weak correlation.</p><p><strong>Conclusion: </strong>The CFS-España and FRAIL-España scales are reliable for assessing frailty in critically ill patients by nurses and/or intensive care physicians.</p>\",\"PeriodicalId\":94139,\"journal\":{\"name\":\"Medicina intensiva\",\"volume\":\" \",\"pages\":\"502131\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-01-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Medicina intensiva\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1016/j.medine.2025.502131\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medicina intensiva","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.medine.2025.502131","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Intrarater and interrater reliability of the Clinical Frailty Scale-Es and FRAIL-Es in critically ill patients.
Objective: To evaluate the intrarater and interrater reliability of the Clinical Frailty Scale-Spain (CFS-España) and FRAIL-España and the internal consistency of the FRAIL-España when implemented in critically ill patients by intensive care nurses and physicians.
Design: Descriptive, observational and metric study.
Setting: intensive care unit (ICU) of Spain.
Patients: Patients >18 years, with >48 UCI hours.
Intervention: None.
Main variables of interest: On admission, frailty with CFS-España and FRAIL-España (by 3 nurses and 2 intensive care physicians), sex, age, comorbidities and severity.
Results: 1045 assessments were performed in 206 patients. Not frail patients on admission: 53% according to the CFS-Spain and 34% according to the FRAIL-Spain. The intraclass correlation coefficient (ICC) shows almost perfect intrarater concordance (>0.80 for CFS-España and >0.90 for FRAIL-España). Agreement by frailty strata (non-fragile, pre-fragile and fragile patients) was substantial or almost perfect, with no major differences in ratings between nurses and physicians. Interprofessional concordance shows an almost perfect ICC for both scales. The lowest agreement was obtained for the FRAIL-España ratings among physicians. In the frailty strata analysis, agreement was moderate. The highest agreement for the CFS-España was considering level 4 patients as frail. High reliability of the FRAIL-España and strong correlation of all dimensions with the global assessment were obtained, except for the comorbidities dimension, with a weak correlation.
Conclusion: The CFS-España and FRAIL-España scales are reliable for assessing frailty in critically ill patients by nurses and/or intensive care physicians.
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