Outcomes for frail very old patients in the ICU are remarkably good

… but how are we deciding which patients are selected for ICU referral and admission?

Frailty reflects reduced physiological reserve and consequently increased vulnerability to physiological stressors.1 Frailty can provide valuable prognostic information, independent of age, regarding patients in acute and critical care,2,3 and the concept can be useful when explaining to clinical staff who are not geriatric specialists, as well as to patients and their families, why some older patients are likely to fare less well than others.4 Such prognostic information may be particularly pertinent for decisions about invasive or burdensome treatments, such as intensive care, and when deciding whether meaningful health benefits are likely to accrue that justify the physical, emotional, and resource costs of therapy.