What type of study is this?

This is a Cross-Sectional Study study.

What question did this study set out to answer?

To assess the relationship between frailty measured by HFRS and in-hospital mortality following pancreatectomy in adults aged ≥65 with pancreatic cancer.

January 14, 2026

Hospital Frailty Risk Score and in-hospital mortality after pancreatectomy in adults ≥65: A national analysis (NIS 2020–2022).

Key Points

To assess the relationship between frailty measured by HFRS and in-hospital mortality following pancreatectomy in adults aged ≥65 with pancreatic cancer.
Cross-sectional analysis utilizing the National Inpatient Sample from 2020–2022
Inclusion of adults aged ≥65 years with pancreatic cancer who underwent pancreatectomy
Frailty assessed using Hospital Frailty Risk Score, categorized as low, intermediate, or high
Weighted logistic regression models used to analyze mortality risk while adjusting for age, sex, and Charlson Comorbidity Index.
Cohort included 3,637 unweighted discharges, representing 18,185 weighted hospitalizations
Greatest mortality observed in high frailty group at 17.86%, compared to 0.28% in low frailty
Each one-point increase in HFRS corresponds to a 27% increase in odds of in-hospital death
Frailty identified as a strong predictor of perioperative mortality risk independent of age and comorbidities.

Abstract

738 Background: Frailty reflects physiological vulnerability and has emerged as a potent predictor of adverse surgical outcomes. In pancreatic cancer, pancreatectomy offers the only potential cure but carries high perioperative risk, particularly for older adults. While comorbidity indices are commonly used in risk assessment, the incremental prognostic value of frailty, measured with the Hospital Frailty Risk Score (HFRS), has not been well characterized in this setting. Methods: We conducted a cross-sectional analysis using the 2020–2022 National Inpatient Sample to identify adults aged ≥65 years with pancreatic cancer who underwent pancreatectomy. Frailty was measured using the HFRS, categorized as low (15). We applied survey-weighted methods accounting for complex sampling design to describe baseline characteristics, estimate in-hospital mortality rates, and compare mortality across frailty categories. Weighted logistic regression models examined associations between frailty and mortality, adjusting for age, sex, and Charlson Comorbidity Index (CCI). Results: The cohort included 3,637 unweighted discharges, representing 18,185 weighted hospitalizations. Weighted prevalence of frailty categories was 67.8% (95% CI 66.0–69.5) low, 29.9% (28.2–31.6) intermediate, and 2.31% (1.87–2.85) high frailty. In-hospital mortality increased markedly with frailty severity: 0.28% (0.07–0.49) for low, 5.24% (3.91–6.57) for intermediate, and 17.86% (9.59–26.12) for high frailty (p15) 2.31 (1.87–2.85) 17.86 (9.59–26.12) HFRS = Hospital Frailty Risk Score from ICD-10 coding. Estimates are survey-weighted to reflect national hospitalizations.

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