{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:59:40Z","timestamp":1790744380862,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Triage reflects acute urgency, whereas frailty may also influence disposition in older emergency department (ED) patients. This study aimed to estimate the association between Clinical Frailty Scale (CFS)\u2010defined frailty and hospitalization after ED evaluation within Japan Triage and Acuity Scale (JTAS) categories and assess whether the strength varied across triage categories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a single\u2010center retrospective cohort study in an urban tertiary hospital in Japan. We identified consecutive triaged ED visits by patients aged \u2265\u200965\u2009years from November 2025 to March 2026. Visits with CFS scores and covariates constituted the complete\u2010case cohort. CFS \u2265\u20095 was defined as frailty. The primary outcome was admission to the study hospital or acute\u2010care interhospital transfer. We used a mixed\u2010effects logistic regression model with a CFS\u2010by\u2010JTAS interaction term, adjusting for age, sex, mode of arrival, injury\u2010 or poisoning\u2010related visit, living arrangement, and long\u2010term care needs certification, with patient\u2010level random intercept. The global interaction was assessed using a likelihood\u2010ratio test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 3127 ED visits, 1526 resulted in hospitalization. In JTAS 1, the adjusted odds ratio (OR) for CFS \u2265\u20095 was not estimated because of quasi\u2010complete separation. In the model excluding JTAS 1, the adjusted OR was 1.00 (95% confidence interval [CI], 0.65\u20131.55) in JTAS 2, 1.54 (95% CI: 1.19\u20131.99) in JTAS 3, and 2.01 (95% CI: 1.13\u20133.58) in JTAS 4\/5. The global CFS\u2010by\u2010JTAS interaction was not statistically significant (P for interaction\u2009=\u20090.091).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Category\u2010specific estimates suggested little association in JTAS 2 but were numerically larger in JTAS 3 and JTAS 4\/5. However, the global interaction was nonsignificant, providing insufficient evidence that the association differed across categories. Prospective studies should examine the clinical, geriatric, social, decision\u2010related, and healthcare\u2010system factors that may underlie this association among older patients with comparable triage\u2010assessed urgency.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acem.70419","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:32:01Z","timestamp":1790742721000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Frailty and Hospitalization After Emergency Department Evaluation Within Triage Categories in Older Patients: A Retrospective Cohort Study"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-9374-396X","authenticated-orcid":false,"given":"Natsumi","family":"Hata","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine Hyogo Prefectural Amagasaki General Medical Center  Amagasaki Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4965-4377","authenticated-orcid":false,"given":"Masaaki","family":"Nagae","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Hyogo Prefectural Amagasaki General Medical Center  Amagasaki Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Umegaki","sequence":"additional","affiliation":[{"name":"Department of Community Healthcare and Geriatrics, Graduate School of Medicine Nagoya University  Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/j.annemergmed.2006.05.019","article-title":"Triage in Medicine, Part I: Concept, History, and Types","volume":"49","author":"Iserson K. V.","year":"2007","journal-title":"Annals of Emergency Medicine"},{"key":"e_1_2_11_3_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2018-026471","article-title":"Performance of Triage Systems in Emergency Care: A Systematic Review and Meta\u2010Analysis","volume":"9","author":"Zachariasse J. M.","year":"2019","journal-title":"BMJ Open"},{"key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1136\/emj.2009.077081","article-title":"Emergency Department Triage Revisited","volume":"27","author":"FitzGerald G.","year":"2010","journal-title":"Emergency Medicine Journal"},{"key":"e_1_2_11_5_1","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1016\/j.jclinepi.2009.07.009","article-title":"Challenges in the Validation of Triage Systems at Emergency Departments","volume":"63","author":"Moll H. A.","year":"2010","journal-title":"Journal of Clinical Epidemiology"},{"key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1016\/j.annemergmed.2018.09.022","article-title":"Triage Performance in Emergency Medicine: A Systematic Review","volume":"74","author":"Hinson J. S.","year":"2019","journal-title":"Annals of Emergency Medicine"},{"key":"e_1_2_11_7_1","volume-title":"Reiwa 7 Nenban Kyukyu Kyujyo no Genkyo [Current Status of Emergency and Rescue Services in 2025]","author":"Fire and Disaster Management Agency, Ministry of Internal Affairs and Communications","year":"2026"},{"key":"e_1_2_11_8_1","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1111\/aas.13342","article-title":"Impact of Age on the Discriminative Ability of an Emergency Triage System: A Cohort Study","volume":"63","author":"Kuriyama A.","year":"2019","journal-title":"Acta Anaesthesiologica Scandinavica"},{"key":"e_1_2_11_9_1","doi-asserted-by":"crossref","first-page":"2159","DOI":"10.1016\/j.ajem.2019.03.006","article-title":"Validity of the Japan Acuity and Triage Scale in Elderly Patients: A Cohort Study","volume":"37","author":"Kuriyama A.","year":"2019","journal-title":"American Journal of Emergency Medicine"},{"key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1017\/cem.2018.17","article-title":"Characteristics and Outcomes of Older Emergency Department Patients Assigned a Low Acuity Triage Score","volume":"20","author":"Hendin A.","year":"2018","journal-title":"CJEM"},{"key":"e_1_2_11_11_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.acepjo.2025.100247","article-title":"A Model for Developing Subspecialty Clinical Practice Guidelines: The Geriatric Emergency Department Guidelines 2.0","volume":"6","author":"Gunaga S.","year":"2025","journal-title":"JACEP Open"},{"key":"e_1_2_11_12_1","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1001\/jamainternmed.2023.2149","article-title":"Association of Functional Status, Cognition, Social Support, and Geriatric Syndrome With Admission From the Emergency Department","volume":"183","author":"Smulowitz P. B.","year":"2023","journal-title":"JAMA Internal Medicine"},{"key":"e_1_2_11_13_1","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1056\/NEJMra2301292","article-title":"Frailty in Older Adults","volume":"391","author":"Kim D. H.","year":"2024","journal-title":"New England Journal of Medicine"},{"key":"e_1_2_11_14_1","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1503\/cmaj.050051","article-title":"A Global Clinical Measure of Fitness and Frailty in Elderly People","volume":"173","author":"Rockwood K.","year":"2005","journal-title":"CMAJ"},{"key":"e_1_2_11_15_1","doi-asserted-by":"crossref","first-page":"254","DOI":"10.5770\/cgj.23.463","article-title":"Using the Clinical Frailty Scale in Allocating Scarce Health Care Resources","volume":"23","author":"Rockwood K.","year":"2020","journal-title":"Canadian Geriatrics Journal"},{"key":"e_1_2_11_16_1","doi-asserted-by":"crossref","first-page":"2407","DOI":"10.1007\/s11739-022-03042-5","article-title":"Frailty Assessment in Emergency Medicine Using the Clinical Frailty Scale: A Scoping Review","volume":"17","author":"Fehlmann C. A.","year":"2022","journal-title":"Internal and Emergency Medicine"},{"key":"e_1_2_11_17_1","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.ejim.2017.09.036","article-title":"Screening of the Frail Patient in the Emergency Department: A Systematic Review","volume":"45","author":"J\u00f8rgensen R.","year":"2017","journal-title":"European Journal of Internal Medicine"},{"key":"e_1_2_11_18_1","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1186\/s12873-024-01123-6","article-title":"Revisits and Frailty in Older Patients in the Emergency Department: A Prospective Observational Multicenter Study","volume":"24","author":"Johansson H.","year":"2024","journal-title":"BMC Emergency Medicine"},{"key":"e_1_2_11_19_1","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/j.annemergmed.2020.03.028","article-title":"Validation of the Clinical Frailty Scale for Prediction of Thirty\u2010Day Mortality in the Emergency Department","volume":"76","author":"Kaeppeli T.","year":"2020","journal-title":"Annals of Emergency Medicine"},{"key":"e_1_2_11_20_1","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1016\/j.annemergmed.2020.09.006","article-title":"Does the Clinical Frailty Scale at Triage Predict Outcomes From Emergency Care for Older People?","volume":"77","author":"Elliott A.","year":"2021","journal-title":"Annals of Emergency Medicine"},{"key":"e_1_2_11_21_1","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1017\/cem.2019.432","article-title":"Examining the Relationship Between Triage Acuity and Frailty to Inform the Care of Older Emergency Department Patients: Findings From a Large Canadian Multisite Cohort Study","volume":"22","author":"Mowbray F.","year":"2020","journal-title":"CJEM"},{"key":"e_1_2_11_22_1","volume-title":"Emergency Decision Support System: Japan Triage and Acuity Scale 2017 Guidebook","author":"Japanese Association for Acute Medicine","year":"2017"},{"key":"e_1_2_11_23_1","volume-title":"Labour and Welfare. Long\u2010Term Care Insurance System","author":"Ministry of Health","year":"2024"},{"key":"e_1_2_11_24_1","volume-title":"International Statistical Classification of Diseases and Related Health Problems, 10th Revision: Chapter XIX, Injury, Poisoning and Certain Other Consequences of External Causes (S00\u2013T98)","author":"World Health Organization","year":"2019"},{"key":"e_1_2_11_25_1","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1111\/ggi.15092","article-title":"Validation of the Japanese Version of the Clinical Frailty Scale","volume":"25","author":"Komiya H.","year":"2025","journal-title":"Geriatrics & Gerontology International"},{"key":"e_1_2_11_26_1","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.ajem.2023.01.002","article-title":"Integrating the Clinical Frailty Scale With Emergency Department Triage Systems for Elder Patients: A Prospective Study","volume":"66","author":"Ng C.\u2010J.","year":"2023","journal-title":"American Journal of Emergency Medicine"},{"key":"e_1_2_11_27_1","doi-asserted-by":"crossref","first-page":"955","DOI":"10.3390\/medicina60060955","article-title":"Validation of the Korean Version of the Clinical Frailty Scale\u2010Adjusted Korean Triage and Acuity Scale for Older Patients in the Emergency Department","volume":"60","author":"Chung H. S.","year":"2024","journal-title":"Medicina (Kaunas, Lithuania)"},{"key":"e_1_2_11_28_1","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1186\/1757-7241-19-68","article-title":"The Validity of the Canadian Triage and Acuity Scale in Predicting Resource Utilization and the Need for Immediate Life\u2010Saving Interventions in Elderly Emergency Department Patients","volume":"19","author":"Lee J. Y.","year":"2011","journal-title":"Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine"}],"container-title":["Academic Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acem.70419","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/acem.70419","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acem.70419","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:32:39Z","timestamp":1790742759000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/acem.70419"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,29]]},"references-count":27,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/acem.70419"],"URL":"https:\/\/doi.org\/10.1111\/acem.70419","archive":["Portico"],"relation":{},"ISSN":["1069-6563","1553-2712"],"issn-type":[{"value":"1069-6563","type":"print"},{"value":"1553-2712","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,29]]},"assertion":[{"value":"2026-06-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70419"}}