Khaw MJ, Chin WV. Integrating frailty and acute illness severity scoring for risk stratification in acute geriatric care: Review and practical guide. World J Crit Care Med 2026; 15(3): 120866 [DOI: 10.5492/wjccm.120866]
Corresponding Author of This Article
Mae-Jane Khaw, MD, MRCP, Division of Geriatric Medicine, Sarawak General Hospital, Jalan Tun Ahmad Zaidi Adruce, Kuching 93586, Sarawak, Malaysia. janekhaw@gmail.com
Research Domain of This Article
Critical Care Medicine
Article-Type of This Article
review-article
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Khaw MJ, Chin WV. Integrating frailty and acute illness severity scoring for risk stratification in acute geriatric care: Review and practical guide. World J Crit Care Med 2026; 15(3): 120866 [DOI: 10.5492/wjccm.120866]
World J Crit Care Med. Sep 9, 2026; 15(3): 120866 Published online Sep 9, 2026. doi: 10.5492/wjccm.120866
Integrating frailty and acute illness severity scoring for risk stratification in acute geriatric care: Review and practical guide
Mae-Jane Khaw, Wei-Ven Chin
Mae-Jane Khaw, Division of Geriatric Medicine, Sarawak General Hospital, Kuching 93586, Sarawak, Malaysia
Wei-Ven Chin, Division of Acute Internal Medicine, Sarawak General Hospital, Kuching 93586, Sarawak, Malaysia
Author contributions: Khaw MJ conceptualized the study, performed the literature review, and wrote the original draft of the manuscript; Chin WV provided supervision, contributed to the conceptual framework, and performed a critical revision of the manuscript; both authors have read and approved the final version of the manuscript.
AI contribution statement: The authors utilized Gemini 3 Flash (Google) for language polishing and formatting assistance only. No portion of the main text, including the abstract, introduction, materials and methods, results, discussion, or conclusion, was AI-generated. The tool was not used for translation, data analysis, or writing assistance. Furthermore, the tool played no role in the study design or the interpretation of results. No images within this mini-review were generated by AI. The authors have personally reviewed and revised all content to ensure clinical accuracy and take full responsibility for the originality and integrity of the manuscript.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest related to this manuscript.
Corresponding author: Mae-Jane Khaw, MD, MRCP, Division of Geriatric Medicine, Sarawak General Hospital, Jalan Tun Ahmad Zaidi Adruce, Kuching 93586, Sarawak, Malaysia. janekhaw@gmail.com
Received: March 11, 2026 Revised: May 1, 2026 Accepted: May 25, 2026 Published online: September 9, 2026 Processing time: 163 Days and 18.6 Hours
Core Tip
Core Tip: Conventional acute illness severity scoring often neglects baseline frailty, leading to inaccurate risk stratification in acute and critical care settings. This mini-review proposes a novel framework comprising a synergistic 2 × 2 risk stratification matrix and a 4-step clinical triage algorithm that integrates acute illness severity scores with the “Two-Week Rule” for baseline Clinical Frailty Scale assessment. By identifying distinct clinical phenotypes, specifically masked resilience and masked risk, clinicians can move beyond one-dimensional triage to make precise, person-centered decisions regarding treatment escalation and goals-of-care planning. This ensures acute geriatric care remains medically proportionate to attainable functional recovery rather than simple physiological stabilization.
