Predictive Value of Frailty Scores and Admission Laboratory Markers for Postoperative ICU Mortality (GERI-MORTAL)

Predictive Value of the Clinical Frailty Scale, Katz ADL, and Admission Laboratory Markers for Postoperative ICU Mortality in Geriatric Patients: A Prospective Observational Study

This prospective observational study aims to evaluate the predictive value of the Clinical Frailty Scale (CFS), the Katz Activities of Daily Living (ADL) scale, and admission laboratory markers for postoperative mortality among geriatric patients admitted to the intensive care unit (ICU) after surgery. Frailty assessment and functional status are increasingly recognized as determinants of outcomes in older adults, yet their combined predictive power with routine laboratory parameters at ICU admission remains unclear. By systematically collecting clinical scores and laboratory data at the time of ICU admission, this study seeks to identify early predictors of mortality and support risk-stratification in geriatric postoperative patients.

Study Overview

• Status: Completed
• Conditions: Postoperative Complications; Activities of Daily Living; Postoperative Mortality; Frailty at Older Adults

Detailed Description

This prospective observational study aims to evaluate the predictive value of the Clinical Frailty Scale (CFS), Katz Activities of Daily Living (ADL) score, and admission laboratory markers for postoperative ICU mortality in geriatric patients. Frailty and functional dependency are known to influence postoperative outcomes; however, their combined role alongside early biochemical indicators at the time of ICU admission has not been well defined in this population.

In this study, patients aged 65 years and older who are admitted to the intensive care unit following surgery will be assessed using the CFS and Katz ADL scores within the first hours of ICU admission. Laboratory data obtained at the time of admission-including complete blood count, renal and hepatic panels, electrolytes, markers of inflammation, and arterial blood gas parameters-will be recorded. Patients will subsequently be followed throughout their ICU stay to document clinical course and outcomes, with ICU mortality designated as the primary endpoint.

The goal of this research is to identify which frailty indicators and laboratory markers are independently associated with mortality, and to explore whether combining functional status scores with early laboratory abnormalities improves risk stratification in geriatric postoperative ICU patients. The findings may support the development of simple, bedside-applicable tools for early mortality prediction and clinical decision-making in this high-risk population.

• Study Type: Observational
• Enrollment (Actual): 393

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Malatya, Turkey (Türkiye), 44000
    • Malatya Eğitim Araştırma Hastanesi

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

This study will include geriatric patients aged 65 years and older who have undergone elective or emergency surgery and require postoperative monitoring in the intensive care unit for at least 24 hours. Patients must provide informed consent personally or through a legally authorized representative

Description

Inclusion Criteria:

Individuals aged 65 years and older Undergoing elective or emergency surgery Monitored in the intensive care unit for at least 24 hours after surgery Provision of informed consent by the patient or the legal representative

Exclusion Criteria:

Patients with incomplete or unavailable data sets ICU stays shorter than 24 hours Patients admitted for organ transplantation or those in the terminal stage receiving palliative care

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Geriatric Postoperative ICU Cohort; This cohort includes geriatric patients (≥65 years) admitted to the intensive care unit after surgery. All participants are followed prospectively to evaluate clinical frailty, functional status, and admission laboratory parameters in relation to postoperative ICU mortality.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
30-day ICU Mortality	Mortality status will be determined at the time of ICU discharge. Mortality is defined as all-cause death occurring during the postoperative ICU stay. Data will be collected prospectively from the electronic medical record and verified by the ICU clinical team. The outcome will be recorded as a binary variable (survived / died)	30 days after ICU admission

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Rate of ICU Length of Stay in Geriatric Postoperative Patients	Duration of stay in the intensive care unit, recorded in days. Longer ICU stay is often associated with increased frailty, limited functional capacity, and higher physiological burden. This variable will be extracted from the clinical records and analyzed in relation to frailty, Katz ADL score, and admission laboratory markers.	From ICU admission to ICU discharge (up to 28 days)
Association Between Laboratory Markers and Frailty Scores	Correlation analysis between baseline laboratory parameters (e.g., hemoglobin, creatinine, CRP, albumin) and frailty assessments (Clinical Frailty Scale and Katz ADL).	At ICU admission

Collaborators and Investigators

• Sponsor: Malatya Egitim Ve Arastirma Hastanesi
• Investigators: Principal Investigator: Leman Acun Delen, MD, Assoc. Prof., Malatya Training and Research Hospital, Department of Anesthesiology and Intensive Care

Publications and helpful links

General Publications

• Moisi L, Mino JC, Guidet B, Vallet H. Frailty assessment in critically ill older adults: a narrative review. Ann Intensive Care. 2024 Jun 18;14(1):93. doi: 10.1186/s13613-024-01315-0.
• Chen W, Chen M, Qiao X. Interaction of lactate/albumin and geriatric nutritional risk index on the all-cause mortality of elderly patients with critically ill heart failure: A cohort study. Clin Cardiol. 2023 Jul;46(7):745-756. doi: 10.1002/clc.24029. Epub 2023 May 24.
• Hanci P, Temel E, Bilir F, Kaya BS. Lactate to albumin ratio as a determinant of intensive care unit admission and mortality in hospitalized patients with community-acquired pneumonia. BMC Pulm Med. 2025 May 9;25(1):224. doi: 10.1186/s12890-025-03698-7.

Study record dates

Study Major Dates

• Study Start (Actual): September 1, 2025
• Primary Completion (Actual): April 1, 2026
• Study Completion (Actual): April 15, 2026

Study Registration Dates

• First Submitted: November 26, 2025
• First Submitted That Met QC Criteria: December 9, 2025
• First Posted (Actual): December 12, 2025

Study Record Updates

• Last Update Posted (Actual): June 1, 2026
• Last Update Submitted That Met QC Criteria: May 29, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Frailty; ICU Mortality; Geriatric Surgery
• Additional Relevant MeSH Terms: Pathologic Processes; Pathological Conditions, Signs and Symptoms; Frailty; Postoperative Complications
• Other Study ID Numbers: MEAH-GER-ICU-2025-01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Due to institutional policies, patient privacy concerns, and local ethical regulations, individual-level clinical data cannot be shared publicly. Only aggregated and anonymized results will be reported.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No