We would like to express our sincere gratitude for the thoughtful comments made by Cheung et al. in their response to our letter [1]. We evaluated the distribution and prognostic relevance of previously proposed surrogate parameters for frailty, Clinical Frailty Scale (CFS)[2–4] and the FRAIL checklist [5], in our database and found that in the univariate analysis, both were associated with 90-day mortality. However, after multivariable adjustment for age, gender, SOFA score, and the presence of therapy goal limitations, only the CFS, but not the FRAIL checklist, was still associated with mortality. We concluded that the CFS has added value compared to the FRAIL checklist. Cheung et al. pointed out that the rate of patients with CFS> 4 was higher than those with

FRAIL> 0. We agree with Cheung et al.’s assessment that the items of the FRAIL checklist are less concrete than the pictograms of the CFS, and this could be a …