{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T12:53:05Z","timestamp":1791895985574,"version":"4.3.4"},"reference-count":36,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Increasing numbers of patients aged \u2265\u200990 years require elective surgery. Frailty is increasingly recognised as a key determinant of peri\u2010operative risk, but high\u2010quality evidence to understand the impact on outcomes in this age group is limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study using the Australian and New Zealand Intensive Care Society Adult Patient Database. Patients aged \u2265\u200990 years admitted to ICU following elective surgery were included, encompassing planned and unplanned ICU admissions. Frailty was assessed at ICU admission using the Clinical Frailty Scale and patients categorised as non\u2010frail or frail. Propensity score matching was performed to balance age; sex; acute illness severity; and comorbidities. Primary outcome was 1\u2010year all\u2010cause mortality. Secondary outcomes included ICU mortality; in\u2010hospital mortality; return to pre\u2010admission residence; and ICU and duration of hospital stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The matched cohort comprised 5398 patients (2699 without frailty (Clinical Frailty Scale  1\u20134) and 2699 living with frailty (Clinical Frailty Scale  5\u20138)), with good post\u2010matching covariate balance. Mortality in ICU was low and not significantly different between patients who were frail and non\u2010frail. Frailty was independently associated with higher in\u2010hospital mortality (matched hazard ratio (HR) 1.66, 95%CI 1.22\u20132.27, p\u2009=\u20090.001) and higher 1\u2010year mortality (matched HR 1.66, 95%CI 1.47\u20131.87, p\u2009&lt;\u20090.001). Patients without frailty had higher odds of returning to their pre\u2010admission residence at hospital discharge than patients living with frailty (matched OR 1.45, 95%CI 1.29\u20131.62, p\u2009&lt;\u20090.001). Patients who were frail experienced longer hospital stays and higher rates of postoperative complications, including delirium and acute renal failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Among patients aged \u2265\u200990 years undergoing elective surgery with postoperative intensive care admission, frailty is strongly associated with prolonged recovery and worse short and long\u2010term outcomes. Incorporation of frailty assessment into peri\u2010operative pathways may improve risk stratification, shared decision\u2010making and personalised care for patients aged \u2265\u200990 years.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/anae.70435","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T12:26:31Z","timestamp":1791894391000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of clinical frailty on mortality after elective surgery in patients aged \u2265\u200990 years admitted to critical care: a\u00a0\u00a0binational intensive care registry analysis"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0083-8905","authenticated-orcid":false,"given":"Je Min","family":"Suh","sequence":"first","affiliation":[{"name":"Department of Anaesthesia Austin Health  Heidelberg VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7403-7680","authenticated-orcid":false,"given":"Laurence","family":"Weinberg","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Austin Health  Heidelberg VIC Australia"},{"name":"Department of Critical Care University of Melbourne  Parkville VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nattaya","family":"Raykateeraroj","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Faculty of Medicine Siriraj Hospital Mahidol University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anoop","family":"Koshy","sequence":"additional","affiliation":[{"name":"Department of Cardiology Austin Health  Melbourne VIC Australia"},{"name":"Department of Medicine The University of Melbourne  Melbourne VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fawaz Ahmed","family":"Prem Navaz","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Austin Health  Heidelberg VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Cailes","sequence":"additional","affiliation":[{"name":"Department of Cardiology Austin Health  Melbourne VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack L.","family":"Bradbury","sequence":"additional","affiliation":[{"name":"Department of Cardiology Austin Health  Melbourne VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Pilcher","sequence":"additional","affiliation":[{"name":"Department of Intensive Care The Alfred Hospital, Austin Health  Heidelberg VIC Australia"},{"name":"Australian and New Zealand Intensive Care Society (ANZICS) Centre for Outcome and Resource Evaluation  Melbourne VIC Australia"},{"name":"Australian and New Zealand Intensive Care Research Centre Monash University  Melbourne VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong\u2010Kyu","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine Dongguk University Ilsan Hospital  Goyang\u2010si Gyeonggi\u2010do South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,13]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1503\/cjs.009525"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/000313482008600129"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeq335"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13741\u2010025\u201000593\u2010x"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.scrs.2024.101060"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.14910"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100037\u20101608651"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010018\u20106997\u20101"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgo.2025.102205"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102014\u2010006981"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/2151458510394606"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2018.12.006"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2006.08.026"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916\u2010017\u20100986\u20102"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(12)62167\u20109"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jfma.2023.07.006"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054\u2010025\u201005612\u20103"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102024\u2010093119"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccrj.2023.04.009"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877\u2010020\u201001801\u20107"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.050051"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00068\u2010021\u201001627\u2010x"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.130639"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1308\/rcsann.2016.0048"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13613\u2010022\u201001080\u2010y"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12871\u2010025\u201002994\u20103"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0156444"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2021.106563"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054\u2010025\u201005349\u2010z"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.17028"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0000000000000065"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.17085\/apm.25480"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0000000000001221"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423\u2010021\u201002128\u20106"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyx010"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11899\u2010025\u201000750\u20105"}],"container-title":["Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/anae.70435","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/anae.70435","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/anae.70435","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T12:26:32Z","timestamp":1791894392000},"score":1,"resource":{"primary":{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/10.1111\/anae.70435"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,13]]},"references-count":36,"alternative-id":["10.1111\/anae.70435"],"URL":"https:\/\/doi.org\/10.1111\/anae.70435","archive":["Portico"],"relation":{},"ISSN":["0003-2409","1365-2044"],"issn-type":[{"value":"0003-2409","type":"print"},{"value":"1365-2044","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,13]]},"assertion":[{"value":"2026-06-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication 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