{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:43:36Z","timestamp":1787751816585,"version":"build-2784847793"},"reference-count":39,"publisher":"Royal College of Surgeons of England","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["annals"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p> The prevalence and complications of biliary disease increase with age. Frailty has been associated with adverse outcomes in the hospital setting. We describe the prevalence of frailty in older patients hospitalised with benign biliary disease and its association with duration of hospital stay, and 90-day and 1-year mortality. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> We performed a retrospective cohort study of patients aged 75 years and over admitted with acute biliary disease between 17 September 2014 and 20 March 2017. Clinical Frailty Scale (CFS) score was recorded on admission. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> We included 200 patients with a median age of 82 (75\u201399) years, 60% were female; 154 (77%) were independent for personal activities of daily living (ADLs) and 99 (49.5%) for instrumental ADLs. Cholecystitis was the most common diagnosis (43%) followed by cholangitis (36%) and pancreatitis (21%). Ninety-nine patients were non frail (NF; CFS 1\u20134) and 101 were frail (F; CFS 5\u20139). Some 104 patients received medical treatment only. Surgery was more common in NF patients (11% vs F 2%), percutaneous drainage more frequently performed in F patients (15% vs NF 5%) and endoscopic cholangiopancreatography was similar in both groups (F 32% vs NF 31%). Frailty was associated with worse clinical outcomes in F vs NF: functional deconditioning (34% vs 11%), increased care level (19% vs 3%), length of stay (12 vs 7 days), 90-day mortality (8% vs 3%) and 1-year mortality (48% vs 24%). <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p> Half of patients in our cohort were frail and spent longer in hospital, were less likely to undergo surgery and were less likely to remain alive at 1 year after discharge. <\/jats:p><\/jats:sec>","DOI":"10.1308\/rcsann.2021.0331","type":"journal-article","created":{"date-parts":[[2022,5,26]],"date-time":"2022-05-26T11:33:27Z","timestamp":1653564807000},"page":"231-240","source":"Crossref","is-referenced-by-count":12,"title":["The influence of frailty on outcomes for older adults admitted to hospital with benign biliary disease: a single-centre, observational cohort study"],"prefix":"10.1308","volume":"105","author":[{"given":"M","family":"Thomas","sequence":"first","affiliation":[{"name":"Salford Royal NHS Foundation Trust, Northern Care Alliance, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Baltatzis","sequence":"additional","affiliation":[{"name":"Salford Royal NHS Foundation Trust, Northern Care Alliance, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Price","sequence":"additional","affiliation":[{"name":"Salford Royal NHS Foundation Trust, Northern Care Alliance, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Fox","sequence":"additional","affiliation":[{"name":"Salford Royal NHS Foundation Trust, Northern Care Alliance, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Pearce","sequence":"additional","affiliation":[{"name":"Salford Royal NHS Foundation Trust, Northern Care Alliance, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Vilches-Moraga","sequence":"additional","affiliation":[{"name":"Salford Royal NHS Foundation Trust, Northern Care Alliance, UK"},{"name":"University of Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"171","reference":[{"key":"C1","unstructured":"National Institute for Health and Clinical Excellence Clinical Knowledge Summary (NICE CKS). Gallstones: How common is it? https:\/\/cks.nice.org.uk\/topics\/gallstones\/background-information\/prevalence\/ (cited February 2023)."},{"key":"C2","doi-asserted-by":"publisher","DOI":"10.1177\/1457496919832147"},{"key":"C3","unstructured":"Association of Upper Gastrointestinal Surgeons. Pathway for the management of acute gallstone diseases. http:\/\/www.augis.org\/Portals\/0\/Guidelines\/Acute-Gallstones-Pathway-Final-Sept-2015.pdf?ver=8SLL3_E_X7VSx4gqyVYd6Q%3D%3D (cited February 2023)."},{"key":"C4","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2018.08.063"},{"key":"C5","unstructured":"Royal College of Surgeons. Commissioning guide: Gallstone Disease Care pathway for gallstone disease [Internet]. (cited March 2021)."},{"key":"C6","unstructured":"National Institute for Health and Clinical Excellence (NICE). Gallstone disease: diagnosis and management. [Internet]. Overview | Gallstone disease: diagnosis and management | Guidance | NICE (cited April 2021)."},{"key":"C7","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v18.i24.3156"},{"key":"C8","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9886"},{"key":"C9","doi-asserted-by":"publisher","DOI":"10.1007\/s40520-017-0879-4"},{"key":"C10","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000003402"},{"key":"C11","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2020.07.003"},{"key":"C12","doi-asserted-by":"publisher","DOI":"10.1111\/anae.12494"},{"key":"C13","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)62167-9"},{"key":"C14","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.050051"},{"key":"C15","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-020-01801-7"},{"key":"C16","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.16907"},{"key":"C17","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afaa180"},{"key":"C18","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afy217"},{"key":"C19","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.11392"},{"key":"C20","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10044"},{"key":"C21","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"C22","unstructured":"National Institute for Health and Clinical Excellence. (NICE). Understanding intermediate care, including reablement. NICE Guideline. [Internet]. https:\/\/www.nice.org.uk\/about\/nice-communities\/social-care\/quick-guides\/understanding-intermediate-care (cited April 2021)."},{"key":"C23","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.329.7462.360"},{"key":"C24","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1983.tb03391.x"},{"key":"C25","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-021-00815-7"},{"key":"C26","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph16193626"},{"key":"C27","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/9.3_Part_1.179"},{"key":"C28","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)31785-4"},{"key":"C29","doi-asserted-by":"publisher","DOI":"10.1007\/s12603-019-1273-z"},{"key":"C30","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2018.4869"},{"key":"C31","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjae.2021.03.005"},{"key":"C32","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d6553"},{"key":"C33","first-page":"CD006211","volume":"7","author":"Ellis G","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"key":"C34","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-017-0390-7"},{"key":"C35","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-016-0082-5"},{"key":"C36","unstructured":"National Institute of Clinical Excellence (NICE). NICE guidance QS 104: Gallstone disease: diagnosis and management. [Internet]. https:\/\/www.nice.org.uk\/guidance\/qs104 (cited June 2021)."},{"key":"C37","doi-asserted-by":"publisher","DOI":"10.1002\/bjs5.50294"},{"key":"C38","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10288"},{"key":"C39","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v26.i14.1638"}],"container-title":["The Annals of The Royal College of Surgeons of England"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publishing.rcseng.ac.uk\/doi\/pdf\/10.1308\/rcsann.2021.0331","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,15]],"date-time":"2023-05-15T10:35:57Z","timestamp":1684146957000},"score":1,"resource":{"primary":{"URL":"https:\/\/publishing.rcseng.ac.uk\/doi\/10.1308\/rcsann.2021.0331"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3]]},"references-count":39,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,3]]}},"alternative-id":["10.1308\/rcsann.2021.0331"],"URL":"https:\/\/doi.org\/10.1308\/rcsann.2021.0331","relation":{},"ISSN":["0035-8843","1478-7083"],"issn-type":[{"value":"0035-8843","type":"print"},{"value":"1478-7083","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3]]}}}