{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T13:34:34Z","timestamp":1788442474145,"version":"build-2803163510"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,4,20]],"date-time":"2025-04-20T00:00:00Z","timestamp":1745107200000},"content-version":"vor","delay-in-days":23,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Emergency 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In a sample of 123\u00a0324 ED visits, CFS scores strongly correlated with adverse outcomes: e.g. for long-term mortality (n\u00a0=\u200933\u00a0475, events\u2009=\u20098871), each CFS single-point increase was associated with a 25% increase in mortality risk (95% CI 1.23\u20131.26). CFS scores varied significantly between raters and across visits, median difference two levels (interquartile range 1\u20133). 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ageing\/afaf093","type":"journal-article","created":{"date-parts":[[2025,3,30]],"date-time":"2025-03-30T16:20:26Z","timestamp":1743351626000},"source":"Crossref","is-referenced-by-count":27,"title":["What can we learn from 68\u00a0000 clinical frailty scale scores? Evaluating the utility of frailty assessment in emergency departments"],"prefix":"10.1093","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6428-0158","authenticated-orcid":false,"given":"Hugh Logan","family":"Ellis","sequence":"first","affiliation":[{"name":"King\u2019s College London, Department of Biostatistics & Health Informatics, Social Genetic and Developmental Psychiatry Centre, Memory Lane , Southwark, London, SE5 8AF ,","place":["UK"]},{"name":"Dalhousie University Ringgold Standard Institution,Department of Medicine , Suite 1421-5955, Veterans' Memorial Lane, Halifax, Nova Scotia, B3H 4R2 ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4642-9334","authenticated-orcid":false,"given":"Liam","family":"Dunnell","sequence":"additional","affiliation":[{"name":"University Hospital Lewisham , Lewisham, London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Eyres","sequence":"additional","affiliation":[{"name":"Princess Royal University Hospital, Department of Clinical Gerontology , Orpington, Bromley, Kent ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4109-9970","authenticated-orcid":false,"given":"Julie","family":"Whitney","sequence":"additional","affiliation":[{"name":"King's College London, The School of Life Course & Population Sciences , Southwark, London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cara","family":"Jennings","sequence":"additional","affiliation":[{"name":"King's College Hospital NHS Foundation Trust, Emergency Department , Lambeth, London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Wilson","sequence":"additional","affiliation":[{"name":"Kings College Hospital NHS 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