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Cohort studyBritish journal of anaesthesia · 2026

Agreement between patient self-reported and assessor-rated frailty using the Clinical Frailty Scale.

Jamal Alkadri, Emily Hladkowicz, Kathryne DesAutels … Daniel I McIsaac

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SurgeryCohort study

Patients' self-reported frailty shows moderate agreement with assessor ratings.

Agreement between patient self-reported and assessor-rated frailty using the Clinical Frailty Scale.

Jamal Alkadri et al. · British journal of anaesthesia · 2026

Background

Guidelines recommend routine preoperative frailty assessment; however, existing data suggest that adherence is low.

Methods

This was a sub study of a multicentre prospective cohort study of people ≥65 yr of age having elective noncardiac surgery.

n = 531 participants

Results

how well patients' own frailty ratings matched trained assessors' ratings

weighted kappa 0.58 (95% CI 0.53 to 0.63)

null 0

0.53

0.63

CI excludes the null - significant

More results

There were 531 participants with both self-reported and assessor-reported CFS.

Assessor-rated scores were systematically higher than self-rated scores by a mean of 0.45 points (95% CI 0.39-0.52; P<0.001).

More results

When predicting death or new disability, paired receiver operating characteristic curve analysis revealed no difference in discriminative capability of self-rated or assessor-rated CFS assessment (c-statistic difference 0.010 [95% CI -0.072 to 0.092; P=0.81]).

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Conclusion

Patients self-report their frailty status using the CFS with moderate agreement to a trained frailty assessor. Self-reported and assessor-rated scores had similar predictive capability for postoperative death or new disability.

Post

Agreement between patient self-reported and assessor-rated frailty using the Clinical Frailty Scale.

Patients' self-reported frailty shows moderate agreement with assessor ratings.

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