BackgroundTo date, most previous studies of frailty among hospitalized elderly Chinese patients have been conducted based on small samples, which cannot represent the elderly patient population. The aim of this study was to identify the prevalence of and risk factors for frailty among elderly patients in China.Study design and settingThis cross-sectional study surveyed 9996 elderly patients from 6 tertiary-level hospitals in China. The prevalence of frailty among patients from selected wards was surveyed by trained investigators. A mixed-effects Poisson regression model was used to analyse the factors associated with frailty among elderly patients.ResultsThe mean age of all subjects was 72.475.77years. The prevalence rate of frailty in this study was 18.02%. After adjustments were made for the confounding effect of the clustering of hospital wards, a mixed-effects Poisson regression model showed that the associated factors of frailty included the following: age (OR: 1.016, 95% CI: 1.012-1.020), BMI<18.5 (OR: 1.248, 95% CI: 1.171-1.330), female gender (OR: 1.058, 95% CI: 1.004-1.115), ethnic minority (OR: 1.152, 95% CI: 1.073-1.236), admission to hospital by the emergency department (OR: 1.104, 95% CI: 1.030-1.184), transit from another hospital (OR: 1.159, 95% CI: 1.049-1.279), former alcohol use (OR: 1.094, 95% CI: 1.022-1.171), fall history in the past 12months (OR: 1.257, 95% CI: 1.194-1.323), vision dysfunction (OR: 1.144, 95% CI: 1.080-1.211), cognition impairment (OR: 1.182, 95% CI: 1.130-1.237), sleeping dysfunction (OR: 1.215, 95% CI: 1.215-1.318), urinary dysfunction (OR: 1.175, 95% CI: 1.104-1.251), and defecation dysfunction (OR: 1.286, 95% CI: 1.217-1.358). The results also showed some of the following protective effects: BMI>28 (OR: 0.897, 95% CI: 0.856-0.940); higher education level, including middle school (OR: 0.915, 95% CI: 0.857, 0.977) and diploma and above (OR: 0.891, 95% CI: 0.821, 0.966); and current alcohol use (OR: 0.869, 95% CI: 0.815, 0.927).ConclusionWe identified a relatively high prevalence of frailty among elderly patients, and there are several associated factors among the population derived from this investigation of a large-scale, multicentre, nationally representative Chinese elderly inpatient population.Trial registration p id=Par Chinese Clinical Trial Registry, ChiCTR1800017682, registered 09 August 2018.