Assessing frailty with clinical and laboratory measures in hospitalized older adults: A comparison of all-cause mortality across two geriatric departments

: By 2030, one in six people globally will be over 60, potentially increasing the burden of frailty, a condition characterized by reduced physiological resilience and poor clinical outcomes. Although frailty affects up to 49 % of hospitalized patients, it is frequently under-recognized. Tools like the Clinical Frailty Scale (CFS) and the FI-Lab aim to assess frailty, though each has limitations. This retrospective cohort study evaluated the predictive value of CFS and FI-Lab, separately and in combination, for in-hospital and three-month post-discharge mortality in older adults. The study included 410 hospitalized patients (median age 87) admitted to two geriatric units between 2023 and 2025. Frailty was assessed using the CFS and a 22-item FI-Lab derived from blood tests within 48 h of admission. In-hospital and post-discharge mortality rates were 12.6 % and 24.7 %, respectively. Both FI-Lab and CFS were independently associated with increased mortality risk. A weak correlation between the two tools (r = 0.19, p < 0.001) suggests they capture distinct but complementary aspects of frailty. These findings support the combined use of FI-Lab and CFS for more accurate risk stratification in acutely ill older adults. FI-Lab may reflect acute physiological stress not captured by clinical measures alone, aiding early identification of vulnerable patients. Despite limitations, including modest sample size and lack of adjustment for multimorbidity, this study highlights the potential utility of integrating lab-based frailty assessments into routine hospital care for personalized geriatric management.