Fraility

Pneumonia is one of the leading causes of infection-related mortality in the older population. Traditional severity scores used in emergency departments, such as the Pneumonia Severity Index (PSI) and CURB-65, primarily focus on acute physiological derangements and may not adequately capture biological reserve and frailty in older adults. Frailty is a geriatric syndrome reflecting increased vulnerability to stressors and reduced recovery capacity. This prospective observational cohort study aims to evaluate the predictive value of the Clinical Frailty Scale (CFS) for in-hospital mortality, 30-day mortality, and morbidity in patients aged 65 years and older presenting to the emergency department with pneumonia. Additionally, the study will assess whether incorporating frailty assessment into existing pneumonia severity scores improves prognostic accuracy.

Frailty is defined as a state of weakness resulting from a decrease in physiological reserves due to physiological changes, diseases, and/or malnutrition associated with advancing age. Frail older adults face increased mortality, morbidity, and healthcare costs when exposed to stressors, making this issue increasingly important. The FRAIL Scale, developed by Morley et al. , is a 5-item measure that assesses frailty. The FRAIL Scale has been validated in many countries and has been proven to be an effective method for detecting frailty. This scale assesses the patient's fatigue, resistance, mobility, weight loss, and other diseases. In the 5-item FRAIL scale, patients receive 0 or 1 point based on their answers, and a total of 0 points is considered non-frail, 1-2 points is considered pre-frail, and \>2 points is considered frail. Frailty is associated with a higher risk of postoperative complications. Rothenberg and colleagues reported in a study involving more than 400,000 patients that frailty doubles the risk of postoperative complications . Hypotension following anesthesia induction is a common complication in geriatric patients. Decreased cardiopulmonary reserve with age leads to an exaggerated drop in blood pressure during induction . In this study, the investigators aimed to determine the effect of frailty level in geriatric patients on hypotension observed after anesthesia induction.