Frailty status and its prediction of long-term mortality in patients with Chronic Constipation and Diarrhea

Abstract Frailty is an emerging health burden but its effect on bowel disorders is unclear. We obtained comprehensive data from the 2009–2010 NHANES and linked mortality data from National Death Index 2019. Frailty was defined by the frailty index composed of routine laboratory data (FI-LAB).Logistic regression was used to explore the association between frailty and bowel disorders. Risk factors for death were identified by Cox proportional hazard regression and used for nomogram formation. The prevalence of frailty was higher in CC (58.3%) and CD (47.7%) than in control (30.6%). CC and CD correlated with increased frailty (ORs 2.6 and 2.2) while frail individuals had higher CD (10.1%, P < 0.001) and CC (11.4%, P < 0.001). CC and CD patients with frailty were older and had higher diabetes, depression, anemia, blood transfusion, and higher mortality (16.5% vs. 2.5%, P = 0.01) than non-frail patients. During a median follow-up of 119 months, frailty was independently associated with a higher risk of all-cause mortality (adjusted HR 21.2). We developed a nomogram: Y = 3.814× frailty index + 0.073 × age, showing an AUC of 0.868/0.816 and high consistencies between the predicted and observed survival probability in the training/validation cohorts.