Introduction
With an aging global population, understanding how frailty impacts on outcomes is vital. We explored the association between frailty & survival in pleural disease using the modified frailty index (mFI), a 5-item co-morbidity-based risk stratification tool.

Aim and Objectives
Assess the prevalence of frailty and its association with mortality in pleural disease.

Methods and Analysis
676 outpatients with pleural disease were identified from a prospectively collected single-centre UK database and their data and notes retrospectively analysed. Individual mFIs were calculated and correlation with mortality analysed. In subgroup analyses, malignant disease was analysed separately given the poor prognosis independent of frailty.

Results
Ages ranged from 23-97 years (mean 70.7, SD 12.5). Positive associations were found between 1 year mortality and both age ?80 (p=0.002, aHR 1.8, 95% CI 1.24-2.62) and frailty (mFI?0.4) (p=0.025, aHR 1.72, 95% CI 1.07-2.76). Subgroup analyses found associations between 1 year mortality and both frailty (p<0.0001, aHR 4.36, 95% CI 2.17-8.77) and malignant disease (p<0.0001, aHR 10.4, 95% CI 6.01-18.02).

Conclusion
This is the first study exploring the relationship between frailty & outcomes in pleural disease. Older & frail patients and those with malignancy had higher 1 year mortality risk. Identifying frail patients at risk of poor outcomes may guide management and prognosis in pleural disease.