Evaluation of the Efficacy of the Clinical Frailty Scale in the Prediction of Prognosis in Geriatric Patients Presenting to the Emergency Department With Acute Abdominal Pathologies: A Prospective Study

OBJECTIVE: The CFS (Clinical Frailty Score) evaluates specific domains including function, comorbidity, and cognition to generate a frailty score ranging from 1 (very fit) to 9 (terminally ill). The aim of this study was to investigate the efficacy of CFS in the prediction of mortality in geriatric patients with acute abdominal pathologies.MATERIAL AND METHODS: Patients over 65 years who presented to the emergency department with acute abdominal pathologies between October 1, 2020 and March 31, 2021 were included in the study. Clinical Frailty Score was calculated and categorized into groups from 1 to 9. Statistical analyses were performed using SPSS version 22.0.RESULTS: The study included 151 patients, of whom 53% were female. The mean age was 75.57±8.078 years. Twenty-two (14.56%) patients died. Clinical Frailty Score was found to be statistically significantly higher in the non-survivor group (p<0.001). Eighty-three (55%) of the patients underwent surgery. There was no statistically significant relationship between Clinical Frailty Score and mortality in the operated and non-operated groups (p=0.613). We added an age of 75 and over as a criterion (Clinical Frailty Score -age) and compared its predictive ability for mortality with CFS. There was no statistically significant difference between Clinical Frailty Score and Clinical Frailty Score-age in terms of the area under the curve values in the prediction of mortality (the area under the curve Clinical Frailty Score and Clinical Frailty Score-age p=0.597, DeLong quality test).CONCLUSIONS: High Clinical Frailty Score and Clinical Frailty Score-age are generally associated with mortality, but this may occur due to non-operation, the thought that medical treatment will be sufficient, or risk information due to comorbidities. In geriatric patients, an increased Clinical Frailty Score may not be sufficient alone in making a surgery decision.