Comparison of frailty screening tools in predicting length of stay and disability in older patients on internal medicine inpatient wards transferred from the emergency department: A retrospective observational study

The aim of this study is to compare frailty screening tools in predicting length of stay (LOS) in older patients on internal medicine inpatient wards transferred from the emergency department (ED). This cross-sectional retrospective study involving 186 subjects aged 65 years or older was conducted at tertiary hospital internal medicine inpatient wards transferred from the ED from September to November 2023. Frailty was defined by the Clinical Frailty Scale (CFS), the identification of Seniors At Risk Tool and the Triage Risk-Screening Tool (TRST). Dependency was defined by Katz Index of Independence in activities of daily living (ADL) and the Lawton instrumental ADL. The presence of frailty according to the CSF and TRST was associated with a long LOS (coefficient of regression β = 0.2 with P < .05). But, in binary logistic regression analysis, there was no association between long LOS and frailty scales. All frailty tools were statistically significant predictors for disability (P < .001). Our findings suggest that, among the tools evaluated, the CFS may be the most robust predictor of both LOS and functional dependency, although its predictive power for actual disability remains limited. Future studies should focus on refining these tools for greater accuracy in predicting functional outcomes and should examine how factors such as polypharmacy and comorbidities impact frailty and hospital outcomes. Additionally, longitudinal studies are needed to establish causative relationships between frailty, LOS, and functional decline.