ORIGINAL RESEARCH article
Front. Med.
Sec. Geriatric Medicine
Association between Frailty Index and All-Cause Mortality in Hospitalized Elderly Patients with Osteoporotic Fractures: A Retrospective Cohort Study
Provisionally accepted
- 1Nanjing Medical University Gusu School, Suzhou, China
- 2First People's Hospital of Kunshan, Kunshan, China
- 3Kunshan First People's Hospital, Kunshan, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Osteoporotic fractures (OPF) represent a significant health concern among the elderly population. Frailty, a prevalent condition in this demographic, can be evaluated via the Frailty Index (FI). This study investigated the association between FI and all-cause mortality (ACM) in aged individuals with osteoporosis (OP). Methods: This retrospective cohort study included 19,332 patients who underwent surgical treatment for fractures at Kunshan First People’s Hospital between January 1, 2017, and August 31, 2023. Among these, 4,782 patients aged ≥ 50 years were diagnosed with OPF. The FI was developed based on 30 health indicators, and it requires the availability of at least 75% of the variables for all patients. Moreover, ACM was monitored from the time of hospitalization until death or the end of the study period. Data on the correlation between FI and ACM were statistically evaluated, including the Cox proportional hazard regression model, interaction test, smooth curve fitting, K-M survival curve, threshold effect, subgroup, and sensitivity analyses. Results: Among the 3,833 patients, the mean age was 68.77 years, with an average FI of 0.07. A substantial positive correlation was observed between FI and ACM (HR = 1.05, 95% CI: 1.03–1.07, p < 0.01). Importantly, a 0.033 increase in the FI score (equivalent to ~ 1 additional cumulative deficit) was related to a 17% higher risk of ACM (HR: 1.17, 95% CI: 1.10 to 1.24). Subgroup analyses further validated these findings across diverse demographic groups. Conclusion: This study establishes a significant correlation between the FI and ACM in elderly patients with OPF, underscoring the importance of frailty measurement in clinical management. These findings support the need for targeted interventions to improve outcomes in this high-risk population and emphasize the necessity of further research to develop effective screening and management strategies. Keywords: Frailty Index, All-cause mortality, Osteoporotic fractures, Elderly patients, Hospitalization
Keywords: Frailty Index, All-cause mortality, Osteoporotic Fractures, elderly patients, Hospitalization
Received: 10 Sep 2025; Accepted: 30 Oct 2025.
Copyright: © 2025 Zhou, Lu, Gong, Jin, Hu, Li and Yin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Chong Li, lichong1705@163.com
Yi Yin, yy-19723@163.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.