Frailty patterns in European surgical patients: The FRAGILE multicentre prospective cohort
Main finding · Association between preoperative frailty and postoperative complications (Clavien-Dindo ≥ II)Result — go to the resultAdjusted odds ratio 2.35 95% CI 1.53–3.60Authors' conclusion
Frailty is common among surgical patients, increases after surgery, and independently predicts postoperative complications and mortality. These findings highlight frailty as a dynamic and potentially modifiable marker of surgical vulnerability that should be routinely assessed and integrated into perioperative care.
Study context
- Population
- Adults undergoing elective or emergency surgery under general or regional anaesthesia
- Participants
- 1,472 patients
- Exposure
- Preoperative frailty (Rockwood Clinical Frailty Scale (CFS), FRAIL questionnaire, Barthel Index) and postoperative outcomes
- Outcome
- Association between preoperative frailty and postoperative complications (Clavien-Dindo ≥ II)
- Follow-up
- 30 days
Methodological details64 participating centres in 10 countries, one to three predefined recruitment days between April 2021 and December 2022
- 64 participating centres in 10 countries
- One to three predefined recruitment days between April 2021 and December 2022
Main finding
As reported in the abstract
Adjusted odds ratio
2.35
95% CI 1.53–3.60
P < 0.001
Preoperative frailty
adjusted OR 2.35 (95% CI 1.53–3.60); P < 0.001
- Postoperative complications, all patients
- 19.2%
Observational data: associations, not effects.
Secondary outcomes
30-day mortality
| OR (95% CI) | P value | ||
|---|---|---|---|
| Preoperative frailty | 10.9 (1.28–93.0) | P = 0.029 | |
| 0.050.21520Odds ratio (log scale) |
Postoperative cognitive impairment
| OR (95% CI) | P value | ||
|---|---|---|---|
| Frailty | 3.47 (1.98–6.08) | P < 0.001 | |
| 0.10.31310Odds ratio (log scale) |
- 30-day mortality — Mortality, all patients
- 1.7%
Preoperative frailty prevalence
- FRAIL
- 14.6%
- CFS
- 10.4%
- Barthel
- 10.4%
New-onset frailty · Within 30 days
- Nonfrail patients who became frail
- 11.9%
- Overall frailty prevalence after surgery
- 21.2%
Original publication
Frailty patterns in European surgical patients: The FRAGILE multicentre prospective cohort. Eur J Anaesthesiol. Published 22 October 2026. doi:10.
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