The following is a summary of “Concordance with routine Clinical Frailty Scale screening in the frailty in European emergency departments (FEED) study,” published in the February 2025 issue of Emergency Medicine by Eagleton et al. 

Frailty screening identifies individuals eligible for geriatric emergency interventions and improves outcomes, but post-implementation evaluations have shown that only about 50% of older Emergency Department (ED) attendees were screened, leaving the reasons for and characteristics of those not screened largely unexplored.  

Researchers conducted a retrospective study to compare routine frailty screening practices with data from a targeted screening study.  

They administered the Clinical Frailty Scale (CFS) in the parent Frailty in European Emergency Departments (FEED) study to consecutive ED attendees on 04 July 2023. This study analyzed a subset of sites with retrievable CFS data from a “normal day” 2 weeks earlier. Symmetry and dependency of missing CFS entries with observed variables were assessed, and the frailty distribution was compared to the parent FEED study data.  

The results showed that only a minority of sites (5/62) recorded CFS data in a retrievable format. Missing entries were 55% on the “normal day” compared to 14% for consecutive attenders in the parent FEED study. While no pattern was observed in the FEED cohort, missing “normal day” CFS data were more frequent among individuals from non-white ethnic groups (76% vs 52% in white groups), self-presenters (68%), and those discharged home from the ED (59%) and CFS distributions significantly differed between routine and research day datasets (P = 0.009).  

Investigators concluded that the systematic omission of CFS assessment during routine screening disproportionately influenced non-white ethnic groups and those with certain self-presentations, raising concerns about the validity of routine CFS data. 

Source: sciencedirect.com/science/article/pii/S1755599X24001605