Background: Frailty is a critical determinant of outcomes in older ICU patients, yet its prevalence and impact remain underexplored. This study aimed to assess the frailty distribution using Fried's phenotype and its association with ICU outcomes among older adults.

Methods: A prospective cohort study of 60 ICU patients aged ≥65 was conducted, categorizing patients into frail, pre-frail, and non-frail groups. Data on demographics, clinical characteristics, frailty criteria, morbidity, mortality, and ICU interventions were analyzed.

Results: Frail patients (n=36) were older (78 ± 5.6 years) and had longer ICU stays (6 ± 2.8 days, p=0.032) compared to pre-frail (n=20) and non-frail (n=4) patients. Significant differences in frailty criteria were observed, with weight loss (65%), weakness (70%), and poor endurance (60%) predominantly seen in the frail group (p<0.001 for each). Morbidity events were significantly higher in frail patients (41.7%, p=0.05), with a trend towards higher in-hospital mortality (19.4%, p=0.08) and inotrope requirement (33.3%, p=0.06).

Conclusion: Frailty significantly affects ICU outcomes, with frail patients experiencing longer stays and higher morbidity. These findings highlight the necessity of integrating frailty assessment into ICU care protocols to tailor interventions and potentially improve outcomes for this vulnerable population.