ArticleFrontiers in medicine2026
Development and validation of a nomogram for predicting frailty among older adults with multimorbidity in the emergency department.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: Frailty is common among older adults with multimorbidity presenting to emergency departments (EDs), yet rapid, practical tools for identifying current frailty status in this setting remain limited. We aimed to identify factors associated with frailty and to develop a clinically applicable nomogram for frailty screening in the ED. Methods: We conducted a hospital-based cross-sectional study including 486 multimorbid adults aged ≥60 years in a tertiary ED. Frailty was assessed using the 5-item FRAIL scale. Candidate variables were pre-specified and screened using the least absolute shrinkage and selection operator (LASSO) regression, and the variables selected by LASSO were then entered into a multivariable logistic regression to develop a model to identify frailty status. The model was developed using the full dataset ( Results: The prevalence of frailty was 32.3%. Six independent factors were retained in the nomogram: number of medications, fall risk, Charlson Comorbidity Index (CCI), nutritional status, anxiety, and ADL dependence. The nomogram demonstrated good discrimination (AUC = 0.877) and remained after 1,000 bootstrap resamples (AUC = 0.883). Calibration was acceptable, with intercepts of -0.028 and slopes of 0.926; Brier scores were 0.133 and 0.140 for the uncalibrated and calibrated logistic models, respectively. The Hosmer-Lemeshow test indicated good model fit ( Conclusion: The nomogram may be an effective tool for assessing current frailty status among multimorbid older adults in an emergency setting. It could support routine frailty screening, facilitate communication among healthcare professionals, and inform individualized care planning.
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