Integrating frailty and acute illness severity scoring for risk stratification in acute geriatric care: Review and practical guide

Table 3 Phenotype-specific clinical implications: Triage, treatment intensity, and goals of care

Clinical phenotype	Triage and disposition	Treatment intensity	GOC strategy
Low risk	Standard ward	Routine monitoring: Focus on preventing functional decline	Goal alignment: Align treatment with baseline patient goals and functional priorities
Masked resilience	ICU/HDU	Full escalation: Aim for return to robust baseline	Justification: Explain how robust reserve justifies intensive care
Masked risk	AGU	High vigilance: Preserve function; prevent delirium	Proactive warning: Highlight “silent severity” and the high risk of rapid functional decline
High risk	ICU/HDU or AGU	Proportionality: TLT of intensive care	Thresholds: Shift focus to dignity if biological limits are met

GOC: Goals of care; HDU: High dependency unit; AGU: Acute geriatric unit; ICU: Intensive care unit; TLT: Time-limited trial.