ArticleAge and ageing2025
What can we learn from 68 000 clinical frailty scale scores? Evaluating the utility of frailty assessment in emergency departments.
Article in Age and ageing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Interplay between frailty and cardiometabolic disorders: from pathophysiology to clinical implications.Cardiovascular diabetology · 2025Pooled it
- Integrating frailty and acute illness severity scoring for risk stratification in acute geriatric care: Review and practical guide.World journal of critical care medicine · 2026Review
- Interpreting p-tau217 on the ward: frailty and plasma biomarkers in acutely admitted older adults.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Why should we assess the degree of frailty in primary care?The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Article
- The interaction between frailty and patient characteristics and its association with hospital-related adverse events in older adults.BMC geriatrics · 2026Article
- The association between the degree of frailty and the risk of hospital related adverse events in older acutely admitted patients.Age and ageing · 2026Observational
- Frailty assessment tools in the emergency department and their predictive value for clinical outcomes: review of the literature.GeroScience · 2026Review
- Frailty classification challenges in the emergency department: agreement and variability in clinical frailty scale scoring.Aging clinical and experimental research · 2026Article
- Frailty Alerts Reduce Waiting Time and Length of Stay in the Emergency Department.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026Observational
- Clinical clusters during acute illness predict long-term mortality in older patients.BMC medicine · 2025Article
- Assessing what matters most in older emergency department patients.Age and ageing · 2025Observational
- Detection of Frailty in Primary Care.Aging medicine (Milton (N.S.W)) · 2025Article
- Can laboratory test-based frailty indices contribute to frailty screening in emergency departments?Age and ageing · 2025Article
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEmergency departments (EDs) in England are under significant strain, with increasing attendances and extended wait times, affecting frail older adults. The clinical frailty scale (CFS) has been implemented as a tool to assess frailty in ED settings, but its reliability and predictive accuracy as a screening tool remain debated.
objectiveTo evaluate the use and variability of the CFS in EDs and its association with patient outcomes, including discharge rates, length of stay, readmission and mortality.
methodsA retrospective cohort study of ED attendances at two London (UK) hospitals from 2017 to 2021. Data included CFS scores, demographics, clinical observations and outcomes. Comparative statistics, logistic regression, Cox proportional hazards models and competing risk regression were applied to examine CFS predictive validity.
resultsIn a sample of 123 324 ED visits, CFS scores strongly correlated with adverse outcomes: e.g. for long-term mortality (n = 33 475, events = 8871), each CFS single-point increase was associated with a 25% increase in mortality risk (95% CI 1.23-1.26). CFS scores varied significantly between raters and across visits, median difference two levels (interquartile range 1-3). Intraclass correlation coefficient analysis showed that 33.1% of CFS score differences was attributable to between-patient differences, 15.4% to inter-rater differences, with 51.5% residual variance from non-frailty factors, such as acute illness severity.
conclusionThe CFS is associated with crucial patient outcomes in the ED. Inter-rater variability and potentially confounding factors can limit its consistency. Automation to enhance CFS score reliability should be explored as a means to support proactive management.
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