The Clinical Frailty Scale and incidence of adverse outcomes in older patients with hip fractures in Qatar

BackgroundStudies conducted on Western populations have shown that the Clinical Frailty Scale (CFS) is a major predictor of adverse outcomes in older patients with hip fractures; however, there are no data on Middle Eastern populations, who may be culturally and ethnically different. We examined the...

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Main Authors: Shirmila Syamala, Francisco José Tarazona-Santabalbina, Jorge Luis Passarelli, Brijesh Sathian, Navas Nadukkandiyil, Hanadi Al Hamad
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1643181/full
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Summary:BackgroundStudies conducted on Western populations have shown that the Clinical Frailty Scale (CFS) is a major predictor of adverse outcomes in older patients with hip fractures; however, there are no data on Middle Eastern populations, who may be culturally and ethnically different. We examined the association between the preoperative Clinical Frailty Scale and multiple adverse outcomes in a cohort of patients with hip fractures (aged 60–96 years) in Qatar.MethodsThis prospective, single-center observational cohort study included 155 patients aged ≥ 60 years with hip fractures from Qatar. These patients underwent a Clinical Frailty Scale assessment at baseline and were followed to evaluate four outcomes of interest: incident delirium, postoperative complications, all-cause mortality within a year, and increased length of stay (LoS) (LoS ≥ 14 days).ResultsA total of 155 patients with hip fractures (average age 74.6 years, 46.5% women) were included in the study. At baseline, 72.2% had a Clinical Frailty Scale score of <5, 12.3% had a score of 5, and 15.5% had a score > 5. Higher baseline scores on the Clinical Frailty Scale were strongly and positively associated with delirium, postoperative complications, and all-cause mortality, but there was no association with length of hospital stay. Compared to the patients with Clinical Frailty Scale scores < 5, those with scores > 5 had significantly higher multivariable risk ratios (RR) (with 95% confidence interval [CI]) for various outcomes. Specifically, the RR for delirium was 7.76 (3.17–18.97), for postoperative complications, it was 3.59 (1.20–10.77), for all-cause mortality, it was 6.39 (1.45–28.20), and for length of stay ≥14 days, it was 1.43 (0.75–2.73).ConclusionThe Clinical Frailty Scale was positively associated with delirium, postoperative complications, and all-cause mortality but not with length of hospital stay in patients with hip fractures from Qatar.
ISSN:2296-858X