Clinical frailty score for hospital outcome for patients aged ≥ 75 following emergency department resuscitation room admission: a retrospective monocenter study.

Elderly patients (≥ 75 years) often require resuscitation room (RR) care in the emergency department (ED), yet decisions regarding intensive care unit (ICU) admission remain complex. Assessment of quality of life and frailty is necessary to determine the level of care required for elderly patients. The Clinical Frailty Scale (CFS) is a validated tool for assessing frailty and predicting mortality, but its role in ICU triage remains unclear. The aim of this study was to compare the CFS of patients admitted to the ICU with those admitted to the general inpatient unit (GIU) after receiving initial intensive care. This was a retrospective, single-center study including patients aged ≥ 75 years admitted to the ED RR from November 1, 2023, to March 31, 2024. The primary outcome was the comparison of CFS between ICU and GIU admissions after RR management. Secondary outcomes included predictive performance of CFS for ICU admission and in-hospital mortality. Of the 392 patients enrolled, 170 (43%) were admitted to the ICU and 222 (57%) to the GIU. The median CFS was 3 (2-4) in ICU-admitted patients and 4 (3-5) in GIU-admitted patients (p < 0.001). In-hospital mortality rate was 30/170 (18%) in the ICU-admitted group and 35/222 (16%) in the GIU-admitted group (p = 0.72). CFS predictive value for ICU admission had an area under the curve of 0.68 (95% confidence interval (95%CI): 0.63-0.73) and for in-hospital mortality of 0.62 (95%CI: 0.55-0.69). In elderly patients admitted to the RR, CFS values differed between those admitted to ICU and those admitted to GIU. However, the discriminative performance of CFS for hospital orientation and in-hospital mortality was limited. These findings suggest that frailty assessment may contribute to the overall evaluation of elderly patients in the ED RR but should be interpreted in conjunction with acute severity scores and clinical judgment.