Jung C, et al. - In a multinational cohort of very old patients (≥80 years; VIP, n=5063), researchers compared outcomes between patients admitted to intensive care unit (ICU) following elective vs acute surgery, as well as, evaluated predictors of mortality, focusing especially on frailty. This study included 922 patients admitted after elective surgery or intervention, 4141 acutely, with 402 after acute surgery. More favorable outcomes (less frequent suffering from frailty as defined as CFS, having lower SOFA scores) were observed in VIPs admitted to ICU after elective surgery as compared to patients following acute surgery even after correction for relevant confounders. In both groups, presence of frailty (CFS >4) was related to significantly increased mortality. Overall, the risk stratification in both patients admitted after elective and acute surgery might be guided by frailty.