Development and validation of a nomogram for predicting frailty among older adults with multimorbidity in the emergency department

Objective: Frailty is common among older adults with multimorbidity presenting to emergency departments (EDs), yet rapid, practical tools for identifying current frailty status in this setting remain limited. We aimed to identify factors associated with frailty and to develop a clinically applicable nomogram for frailty screening in the ED. Methods: = 486) and internally validated using 1,000 bootstrap resamples. Discrimination was evaluated using receiver operating characteristic (ROC) curves and the area under the curve (AUC). Calibration was assessed using calibration plots, the calibration intercept, the calibration slope, and the Brier score. Clinical utility and potential impact were assessed using decision curve analysis (DCA) and clinical impact curves (CIC). Results: = 0.262). DCA and CIC indicated favorable clinical utility and good accuracy in identifying frailty. Conclusion: The nomogram may be an effective tool for assessing current frailty status among multimorbid older adults in an emergency setting. It could support routine frailty screening, facilitate communication among healthcare professionals, and inform individualized care planning.