The episode of care used for analysis in this study was from the time of admission to the acute care surgical service until discharge from hospital or 90 days following admission, whichever occurred first. Patients were enrolled within 48 hours of the index admission. At the time of enrolment, one of us (J.G.B. or P.J.B.D.) interviewed and examined each patient, and a comprehensive geriatric assessment (CGA) was completed. The CGA is a validated multidisciplinary diagnostic tool that expands on the standard medical history and physical examination, including aspects of health important for older adults.13 It includes an assessment of mobility, activities of daily living, residential status, cognition, mood, self-rated health, strength, sleep and social supports.13 The CGA includes a review of systems, a review of medications and medical history. The information from the CGA can be used to calculate a frailty index (FI-CGA).14,15 The FI-CGA is calculated by dividing the number of health deficits a patient has ac cumulated by all measured deficits. Therefore, possible scores rang from 0.00 to 1.00 on a continuous scale. For example, mean index scores of 0.22, 0.36 and 0.43 indicate apparent vulnerability, moderate frailty and severe frailty, respectively.14