Prevalence of Frailty in European Emergency Departments (FEED): an international flash mob study
Authors:   European Taskforce on Geriatric Emergency Medicine (ETGEM) collaborators, Coats Timothy , Conroy Simon , de Groot Bas , Heeren Pieter , Lim Stephen , Lucke Jacinta , Mooijaart Simon , Nickel Christian H. , Penfold Rose , Singler Katrin , van Oppen James D. , Polyzogopoulou Effie , Kruis Arina , McNamara Rosa , de Groot Bas , Castejon-Hernandez Santiago , Miro Oscar , Karamercan Mehmet Akif , Dündar Zerrin Defne , van Oppen James D. , Pavletić Martina , Libicherová Pavla , Balen Frédéric , Benhamed Axel , Dubucs Xavier , Hernu Romain , Laribi Said , Singler Katrin , Fraidakis Othon , Fyntanidou Varvara Polyvios , Polyzogopoulou Effie , Gaal Szabolcs , Jónsdóttir Anna Björg , Kelly-Friel Mary Elizabeth , McAteer Claire Alexandra , Sibthorpe Lisa Diandra , Synnott Aoife , Zazzara Maria Beatrice , Coffeng Sophie Maria , de Groot Bas , Lucke Jacinta Anna , Smits Rosalinde A. L. , Castejon-Hernandez Santiago , Llauger Lluis , Mir Sira Aguiló , Ortiz Miguel Sánchez , Padilla Eduardo Enrique , Rodeles Santiago Cotobal , Rojewski-Rojas Wojciech , Fadini Davide , Jegerlehner Natalie Sabrina , Nickel Christian Hans , Rezzonico Sara , Zucconi Enrico Carlo , Cakmak Sumeyye , Demir Huseyin Avni , Dündar Zerrin Defne , Güven Ramazan , Karamercan Mehmet Akif , Sogut Ozgur , Tayfur Ismail , Adams James Alexander , Bernardo Janice , Brown Leanne , Burton Joel , Butler Matthew James , Claassen Renate Isabelle , Compton Francesca , Cooper Jamie G. , Heyes Ruth , Ko Sally , Lightbody Calvin John , Masoli Jane A. H. , McKenzie Stephen Thomas Gerard , Mawhinney David , Moultrie Nicola Jayne , Price Angeline , Raman Rajendra , Rothwell Lauren Heather , Shashikala Ravishankar Prabhakar , Smith Erica Jane , Sorice Vittoria , van Oppen James D. , Wallace James Michael , Young Tom , Benvin Ana , Breški Edita , Ćefo Alda , Dumić Dijana , Ferenac Rea , Jurica Ivanka , Otočan Marinka , Zinaić Petra Šverko , Clement Bénédicte , Jacquin Laurent , Royer Blandine , Apfelbacher Stefanie Irmgard , Bezati Sofia , Gkarmiri Sofia , Kaltsidou Christina V. , Klonos George , Korka Zoi , Koufogianni Afroditi , Mavros Vasileios , Nano Adamantia , Ntousopoulos Angelos , Papadopoulos Nikolaos , Sason Rakel , Zagalioti Sofia-Chrysovalantou , Hjaltadottir Ingibjörg , Sigurþórsdóttir Ingibjörg , Skuladottir Sigrun Sunna , Thorsteinsdottir Thordis , Breslin Deirdre , Byrne Colm Patrick , Dolan Anita , Harte Olivia , Kazi Durriya , McCarthy Aoife , McMillan Shane Stephen , Moiloa Dineo Ntesang , O’Shaughnessy Íde Louise , Ramiah Vinny , Williams Susan , Giani Tommaso , Levati Elena , Montenero Rossella , Russo Andrea , Salini Sara , van den Berg Bianca , Booijen Anja Martine , Sir Ozcan , Vermeulen Anne Elisabeth , ter Voert Michèle Anna , Alvarez-Galarraga Alicia C. , Azeli Youcef , Gómez Rocío García-Gutiérrez , González González Rebeca , Lizardo Dayris , Pérez Marta López , Madan Coral Núñez , Medina Jesus Ángel , Moreno Javier Sierra , Patiño Erika Vanessa Bolívar , Posada David Martín-Crespo , Rodrigo Irene Cabrera , Vitucci Catherine Franca , Ballinari Marco , Dreher Thomas , Gianinazzi Leone , Espejo Tanguy , Hautz Wolf E. , Rezzonico Sara , Bayramoğlu Burcu , Cakmak Sumeyye , Comruk Burhan , Dogan Tuba , Köse Fulya , Allen Thomas Paul , Ardley Robert , Beith Claire Marie , Boath Keith Alan , Britton Hannah Louise , Campbell Marion Madeleine Françoise , Capel Jonathon , Catney Conall , Clements Suzanne , Collins Brigid Pauline , Compton Francesca , Cook Alison , Cosgriff Emma Jane , Coventry Tina , Doyle Nancileigh , Evans Zoe , Fasina Toluwalase Abdulrazak , Ferrick John Francis , Fleming Gail Mclaughlin , Gallagher Caroline , Golden Mark , Gorania Darshan , Glass Lynn , Greenlees Hannah , Haddock Zara Patricia , Harris Ruth , Hollas Carol , Hunter Amy , Ingham Claire , Ip Shirley Sau Yin , James Jacqueline Anne , Kenenden Christopher , Jenkinson Gabrielle Elizabeth , Lee Emma , Lovick Sophie Amelia , McFadden Margaret , McGovern Roisin , Medhora Jasmine , Merchant Farah , Mishra Srishti , Moreland Gayle Betsy , Narayanasamy Subha , Neal Amy Rebecca , Nicholls Emma Louise , Omar Mariam Turkey , Osborne Noleen , Oteme Favour Oghenevwaire , Pearson Jemma , Price Robert , Sajan Monika , Sandhu Loveleen Kaur , Scott-Murfitt Harriet , Sealey Beth , Sharp Eleanor Paige , Spowage-Delaney Benjamin Andrew Charles , Stephen Fiona , Stevenson Lynn , Tyrrell Ian , Ukoh Chukwunonso Kalu , Walsh Rebekah , Watson Alice May , Whiteford June Elizabeth Cowan , Allston-Reeve Corinne , Barson Thomas James , Giorgi Margherita Grotzkyj , Godhania Yasmin L. , Inchley Vicki , Mirkes Evgeny , Rahman Sajid 
Published: February 2024

Abstract
Introduction
Current emergency care systems are not optimized to respond to multiple and complex problems associated with frailty. Services may require reconfiguration to effectively deliver comprehensive frailty care, yet its prevalence and variation are poorly understood. This study primarily determined the prevalence of frailty among older people attending emergency care.

Methods
This cross-sectional study used a flash mob approach to collect observational European emergency care data over a 24-h period (04 July 2023). Sites were identified through the European Task Force for Geriatric Emergency Medicine collaboration and social media. Data were collected for all individuals aged 65 + who attended emergency care, and for all adults aged 18 + at a subset of sites. Variables included demographics, Clinical Frailty Scale (CFS), vital signs, and disposition. European and national frailty prevalence was determined with proportions with each CFS level and with dichotomized CFS 5 + (mild or more severe frailty).

Results
Sixty-two sites in fourteen European countries recruited five thousand seven hundred eighty-five individuals. 40% of 3479 older people had at least mild frailty, with countries ranging from 26 to 51%. They had median age 77 (IQR, 13) years and 53% were female. Across 22 sites observing all adult attenders, older people living with frailty comprised 14%.

Conclusion
40% of older people using European emergency care had CFS 5 + . Frailty prevalence varied widely among European care systems. These differences likely reflected entrance selection and provide windows of opportunity for system configuration and workforce planning.