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Background Major emergency abdominal surgery is associated with a high risk of morbidity and mortality. Given the ageing and increasingly frail population, understanding the impact of frailty on complication patterns after surgery is crucial. The aim of this study was to evaluate the association between clinical frailty and organ-specific postoperative complications after major emergency abdominal surgery. Methods A prospective cohort study including all patients undergoing major emergency abdominal surgery at Copenhagen University Hospital Herlev, Denmark, from 1 October 2020 to 1 August 2022, was performed. Clinical frailty scale scores were determined for all patients upon admission and patients were then analysed according to clinical frailty scale groups (scores of 1–3, 4–6, or 7–9). Postoperative complications were registered until discharge. Results A total of 520 patients were identified. Patients with a low clinical frailty scale score (1–3) experienced fewer total complications (120 complications per 100 patients) compared with patients with clinical frailty scale scores of 4–6 (250 complications per 100 patients) and 7–9 (277 complications per 100 patients) (P < 0.001). A high clinical frailty scale score was associated with a high risk of pneumonia (P = 0.009), delirium (P < 0.001), atrial fibrillation (P = 0.020), and infectious complications in general (P < 0.001). Patients with severe frailty (clinical frailty scale score of 7–9) suffered from more surgical complications (P = 0.001) compared with the rest of the cohort. Severe frailty was associated with a high risk of 30-day mortality (33% for patients with a clinical frailty scale score of 7–9 versus 3.6% for patients with a clinical frailty scale score of 1–3, P < 0.001). In a multivariate analysis, an increasing degree of clinical frailty was found to be significantly associated with developing at least one complication. Conclusion Patients with frailty have a significantly increased risk of postoperative complications after major emergency abdominal surgery, especially atrial fibrillation, delirium, and pneumonia. Likewise, patients with frailty have an increased risk of mortality within 90 days. Thus, frailty is a significant predictor for adverse events after major emergency abdominal surgery and should be considered in all patients undergoing major emergency abdominal surgery. [ABSTRACT FROM AUTHOR]

Background and Objectives Social isolation (SI) and loneliness are key factors that contribute to frailty among older adults. Current estimates regarding how frailty affects SI and loneliness and how SI and loneliness affect frailty may be flawed due to reverse causality. This study aimed to investigate the bidirectional relationships and mediating effects among SI, loneliness, and frailty among older adults in China. Research Design and Methods The study analyzed data from 6 waves of the Chinese Longitudinal Healthy Longevity Survey conducted between 2002 and 2018. The sample included individuals aged 65 and older. The General Cross-Lagged Panel Model was used to account for confounding factors and reveal mediating effects. Results Our findings specifically indicate a direct effect of SI on frailty, although suggesting that loneliness may indirectly affect frailty through its influence on SI. Additionally, frailty can lead to increased SI and loneliness. Discussion and Implications SI and loneliness are strongly intertwined with frailty among older adults in China. To prevent the development of frailty, public health initiatives should prioritize reducing SI among older adults. Furthermore, efforts to decrease frailty levels can yield positive outcomes by mitigating both SI and loneliness among this population. [ABSTRACT FROM AUTHOR]