Frailty is a syndrome of increased vulnerability to incomplete resolution of homeostasis (healing or return to baseline function) following a stressor event (such as an infection or fall) and it is associated with poor outcomes including increased mortality and reduced quality of life. Prevalence increases with age, but it should not be considered an inevitable consequence of ageing.

The pathophysiology of frailty is poorly understood but the immune and endocrine systems appear to be involved in its development or response. Age and frailty have been proven to be independently predictive of outcomes in patients admitted with an acute illness.

In COVID-19, routine frailty identification has been used to inform decision making about high level of treatment. This is because frailty usually moderates the effect of age on mortality. Anecdotally, this effect has not been recognised by clinicians looking after older COVID-19 patients. Four papers have been published so far on the effect of frailty on COVID-19 with differing results. However, all papers show the independent predictive value of age when controlling for frailty, which is not usually seen in studies of age and frailty in other acute illnesses.

PIONEER geography The West Midlands (WM) has a population of 5.9 million & includes a diverse ethnic & socio-economic mix.

EHR: UHB is one of the largest NHS Trusts in England, providing direct acute services & specialist care across four hospital sites, with 2.2 million patient episodes per year, 2750 beds & an expanded 250 ITU bed capacity during COVID. UHB runs a fully electronic healthcare record (EHR) (PICS; Birmingham Systems), a shared primary & secondary care record (Your Care Connected) & a patient portal “My Health”.

Scope: All patients aged 18 years and above admitted for an acute illness in hospitals within University Hospitals Birmingham NHS trust during the COVID-19 pandemic. The dataset includes highly granular patient demographics & co-morbidities taken from ICD-10 & SNOMED-CT codes. Serial, structured data pertaining to acute care process (timings, staff grades, specialty review, wards), presenting complaint, acuity, all physiology readings (pulse, blood pressure, respiratory rate, oxygen saturations), all blood results, imaging reports, all prescribed & administered treatments (fluids, blood products, procedures), all outcomes.

Available supplementary data: Matched controls; ambulance, synthetic data.

Available supplementary support: Analytics, Model build, validation & refinement; A.I.; Data partner support for ETL (extract, transform & load) process, Clinical expertise, Patient & end-user access, Purchaser access, Regulatory requirements, Data-driven trials, “fast screen” services.