PT - JOURNAL ARTICLE AU - Munir Ehrlington, Samia AU - Hörlin, Erika AU - Toll John, Rani AU - Wretborn, Jens AU - Wilhelms, Daniel TI - Frailty is associated with 30-day mortality: a multicentre study of Swedish emergency departments AID - 10.1136/emermed-2023-213444 DP - 2024 Sep 01 TA - Emergency Medicine Journal PG - 514--519 VI - 41 IP - 9 4099 - http://emj.bmj.com/content/41/9/514.short 4100 - http://emj.bmj.com/content/41/9/514.full SO - Emerg Med J2024 Sep 01; 41 AB - Background Older patients living with frailty have an increased risk for adverse events. The Clinical Frailty Scale (CFS) is a 9-point frailty assessment instrument that has shown promise to identify frail emergency department (ED) patients at increased risk of adverse outcomes. The aim of this study was to investigate the association between CFS scores and 30-day mortality in an ED setting when assessments are made by regular ED staff.Method This was a prospective multicentre observational study carried out between May and November 2021 at three EDs in Sweden, where frailty via CFS is routinely assessed by ED staff. All patients ≥65 years of age were eligible for inclusion. Mortality at 7, 30 and 90 days, admission rate, ED and hospital length of stay (LOS) were compared between patients living with frailty (CFS≥5) and robust patients. Logistic regression was used to adjust for confounders.Results A total of 1840 ED visits of patients aged ≥65 years with CFS assessments done during the study period were analysed, of which 606 (32.9%) were patients living with frailty. Mortality after the index visit was higher in patients living with frailty at 7 days (2.6% vs 0.2%), 30 days (7.9% vs 0.9%) and 90 days (15.5% vs 2.4%). Adjusted ORs for mortality for those with frailty compared with more robust patients were 9.9 (95% CI 2.1 to 46.5) for 7-day, 6.0 (95% CI 3.0 to 12.2) for 30-day and 5.7 (95% CI 3.6 to 9.1) 90-day mortality. Patients living with frailty had higher admission rates, 58% versus 36%, a difference of 22% (95% CI 17% to 26%), longer ED LOS, 5 hours:08 min versus 4 hours:36 min, a difference of 31 min (95% CI 14 to 50), and longer in-hospital LOS, 4.8 days versus 2.7 days, a difference of 2.2 days (95% CI 1.2 to 3.0).Conclusion Patients living with frailty, had significantly higher mortality and admission rates as well as longer ED and in-hospital LOS compared with robust patients. The results confirm the capability of the CFS to risk stratify short-term mortality in older ED patients.Trial registration number NCT04877028.Data are available upon reasonable request. There is no plan to share individual participant data. Personal data related to this study is available upon request. Electronic data is stored in a protected network storage space. The worksheets are stored in a locked space without access for unauthorised personnel.