The Clinical Frailty Scale (CFS) as an Independent Prognostic Factor for Patients ≥80 Years with Small Bowel Obstruction (SBO)

background SBO is a potentially life-threatening condition that often affects older patients. frailty, more than age, is expected to play a crucial role in predicting SBO prognosis in this population. this study aims to define the influence of clinical frailty scale (CFS) on mortality and major complications in patients >= 80 years with diagnosis of SBO at the emergency department (ED).methods all patients aged >= 80 years admitted to our ED for SBO from January 2015 to september 2020 were enrolled. frailty was assessed through the CFS, and then analyzed both as a continuous and a dichotomous variable. the endpoints were in-hospital mortality and major complications.results a total of 424 patients were enrolled. higher mortality (20.8% vs 8.6%, p<0.001), longer hospital stay (9 [range 5-14] days vs 7 [range 4-12] days, p=0.014), and higher rate of major complications (29.9% vs 17.9%, p=0.004) were associated with CFS >= 7. CFS score and bloodstream infection were the only independent prognostic factors for mortality (OR 1.72 [CI: 1.29-2.29], p<0.001; OR 4.69 [CI: 1.74-12.6], p=0.002, respectively). furthermore, CFS score, male sex and surgery were predictive factors for major complications (OR 1.41 [CI: 1.13-1.75], p=0.002; OR 1.67 [CI: 1.03-2.71], p=0.038); OR 1.91 [CI: 1.17-3.12], p=0.01; respectively). at multivariate analysis, for every 1-point increase in CFS score, the odds of mortality and the odds of major complications increased 1.72-fold and 1.41-fold, respectively.conclusion the increase in CFS is directly associated with an increased risk of mortality and major complications. the presence of severe frailty could effectively predict an increased risk of in-hospital death regardless of the treatment administered. the employment of CFS in elderly patients could help the identification of the need for closer monitoring and proper goals of care.