Risk factors for and a prediction nomogram of physical frailty in older patients hospitalized with acute calculous cholecystitis

Frailty increases the risk of complications and delays recovery in older patients with acute calculous cholecystitis (ACC). Early identification is crucial to improving outcomes. Subjects were 386 older inpatients with ACC at two hospitals who were randomly divided into a training set (<i>n</i> = 270) and validation set (<i>n</i> = 116). Patients were categorized into frail and non-frail groups. Binary logistic regression identified significant predictors, and a nomogram was developed. The incidence of frailty was 27% (<i>n</i> = 73). Smoking, a sleep disorder, impaired ADL, and malnutrition were independent predictors for frailty (<i>p</i> < 0.05). The nomogram showed good discrimination (AUC = 0.752), with a sensitivity of 82.6% and a specificity of 67.4%. Calibration was acceptable (Hosmer-Lemeshow <i>χ</i>² = 4.407, <i>p</i> = 0.732), and decision curve analysis demonstrated clinical utility. The developed nomogram reliably predicts the risk of frailty in older patients with ACC and may facilitate targeted early interventions in clinical practice.