SRS106 - A comparison of frailty assessment tools in chronic limb threatening ischaemia

Introduction The vascular surgery population is becoming increasingly frail. Frailty is defined either by the cumulative deficit model or the frailty phenotype. The cumulative deficit model describes frailty as the progressive accumulation of deficits that increase a patient's risk of adverse outcomes. The frailty phenotype is a biological syndrome characterised by physical decline across five domains: weight loss, exhaustion, low activity, slowness, and weakness. There is currently no consensus on the optimal method for assessing frailty in vascular surgical patients. Methods Patients presenting with CLTI were enrolled from our rapid-access clinic between November 2024 and May 2025. Each patient was assessed using the FFP, CFS, and ‘End-of-bed Test’ (EoB). Frailty was defined as FFP ≥3 or CFS ≥5. Correlation was calculated using Spearman’s rank and interrater reliability was assessed with Cohen’s Kappa. Results 139 patients were included. Frailty was identified in 96 (69.1%) using FFP, 94 (67.6%) using CFS, and 100 (71.9%) using EoB. A positive correlation was observed between FFP and CFS (ρ = 0.512, P < 0.001) with moderate agreement (κ = 0.402, P < 0.001). The weakest correlation was between FFP and EoB (ρ = 0.368, P < 0.001) with fair agreement (k = 0.343, P < 0.001) and the strongest between CFS and EoB (ρ = 0.739, P < 0.001) with almost perfect agreement (k = 0.830, P < 0.001). Conclusions Both the CFS and FFP are suitable for use in vascular surgery patients. Further outcome-based analysis is ongoing to determine the most predictive tool for clinical use.