Association between frailty and outcomes in emergency department patients requiring emergency general surgery : a retrospective cohort study

Article Article scientifique Article Association between frailty and outcomes in emergency department patients requiring emergency general surgery : a retrospective cohort study eng 2026-06-26 author Fehlmann Christophe A 633754 Département d'anesthésiologie, pharmacologie et soins intensifs (APSIC) Christophe Fehlmann author Stierlin Clément 779400 author Van Dooren Kristina 824525 author Restellini Romeo 642332 author McIsaac Daniel author Rouyer Frédéric 885902 Département d'anesthésiologie, pharmacologie et soins intensifs (APSIC) author Eagles Debra author Taljaard Monica author Perry Jeffrey 5114 10.57187/5114 42537629 1424-3997 https://smw.ch/index.php/smw/article/view/5114 BACKGROUND: Frailty, a state of increased vulnerability, is a well-established risk factor of adverse outcomes following surgery. While its prognostic value has been demonstrated in various contexts, data are lacking on its impact in emergency general surgery within the Swiss healthcare system. This study aimed to evaluate the association between frailty and outcomes among older patients undergoing emergency general surgery in a Swiss tertiary hospital. METHODS: We conducted a retrospective cohort study including patients aged 65 years or over who underwent emergency general surgery between January 2016 and December 2019. Eligible procedures included laparotomy, bowel resection, peptic ulcer repair, appendectomy and cholecystectomy performed within 72 hours of admission. Frailty was assessed retrospectively using the Clinical Frailty Scale (CFS), based on clinical documentation. The primary outcome was 1-year mortality. Secondary outcomes included complications, hospital length of stay and discharge destination. Multivariable regression models were used to analyse associations. RESULTS: Of 683 patients (median age 76 years; 52.7% female), 38.2% were classified as living with frailty (CFS ≥5). One-year mortality was significantly higher among patients with frailty (25.6%) than those without (6.6%), with an adjusted odds ratio (aOR) of 3.0 (95% CI: 1.7–5.1). Frailty was associated with an increased risk of complications (aOR: 2.3; 95% CI: 1.5–3.6), prolonged hospital stay (+46.4%; 95% CI: 26.8–69.0%) and discharge to a location other than home (aOR: 2.1; 95% CI: 1.4–3.2). CONCLUSION: Frailty is associated with worse outcomes after emergency general surgery in older adults. Routine frailty screening could improve risk stratification and guide patient-centred surgical decision-making. Frailty Emergency department Emergency general surgery Swiss Healthcare Clinical Frailty Scale Dewey 616 Dewey 617 63 Département d'anesthésiologie, pharmacologie, soins intensifs et urgences 229 56 Département de médecine 221 false https://osf.io/8k7yn/overview Swiss medical weekly 156 6 a1797a6e-9364-46b7-a397-7a607d95ea18 Article (Published version) Public Article_scientifique_from_unpaywall.pdf 1145580 application/pdf CC BY-4.0 b3752c4726ee3ec7b9cb9b6d8d9c3a0ed2ad2174c96ce91f96612249da1dd00e openAccess Faculté de médecine / Section de médecine clinique / Département d'anesthésiologie, pharmacologie, soins intensifs et urgences Faculté de médecine / Section de médecine clinique / Département de médecine

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Association between frailty and outcomes in emergency department patients requiring emergency general surgery : a retrospective cohort study	Swiss medical weekly			2026	1	0

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Van Dooren, Kristina