Association between the combined effect of frailty and the estimated glomerular filtration rate and non-elective hospital readmission in elderly inpatients: a cohort study

Ying Liu; Jihong Yang; Hua Wang; Jinmeng Zhou; Jiashun Huang; Hong Shi; Jing Li; Hui Wang; Ji Shen; Yang Liu

doi:10.21037/apm-21-2327

Association between the combined effect of frailty and the estimated glomerular filtration rate and non-elective hospital readmission in elderly inpatients: a cohort study

Ann Palliat Med. 2022 Feb;11(2):766-773. doi: 10.21037/apm-21-2327.

Authors

Ying Liu¹, Jihong Yang², Hua Wang³, Jinmeng Zhou¹, Jiashun Huang¹, Hong Shi⁴, Jing Li⁴, Hui Wang⁵, Ji Shen⁴, Yang Liu⁴

Affiliations

¹ Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China; Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
² Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China; Department of Nephrology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Science, Beijing, China.
³ Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Science, Beijing, China.
⁴ Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
⁵ Department of Nephrology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Science, Beijing, China.

PMID: 35249353
DOI: 10.21037/apm-21-2327

Abstract

Background: This study aims to explore the combined effect of frailty and the estimated glomerular filtration rate (eGFR) and non-elective hospital readmission in elderly inpatients.

Methods: A total of 400 elderly patients were selected. The Fried scale was used to assess frailty. The patients were divided into a non-frailty group and a frailty group. They were divided into a normal eGFR group and a eGFR decreased group. Finally, the patients were divided into the following four groups: Group A (no frailty + eGFR normal); Group B (no frailty + eGFR decreased); Group C (frailty + eGFR normal); and Group D (frailty + eGFR decreased).

Results: The results of the follow-up survival analysis showed the non-elective hospital readmission within 6 months of discharge. Group A, Group B, Group C, and Group D had an incidence of 21%, 26%, 24%, and 36%, respectively. The Kaplan-Meier curves showed the event-free survival rates of Group A and Group C were higher than that of Group D, and there was no significant difference between Group B and Group D. The risk of non-elective hospital readmission within 6 months in patients with a decreased eGFR was 1.777 times higher than that in patients with a normal eGFR [95% confidence interval (CI): 1.001-3.154], while the risk of non-elective hospital readmission within 6 months in frail patients and non-frail patients did not differ significantly. The multivariate Cox regression analysis showed that the risk of non-elective hospital readmission in Group D was 2.295 times higher than that in Group A (95% CI: 1.096-4.810), and the difference was statistically significant. The risk of non-elective hospital readmission in Group B was 1.401 times of that in Group A (95% CI: 0.665-2.953), while that in Group C was 91.8% (95% CI: 0.403-2.092), but the differences were not statistically significant.

Conclusions: A decline in eGFR is associated with non-elective hospital readmission in elderly inpatients within 6 months; however, frailty is not associated with non-elective hospital readmission. The combined effect of frailty and eGFR in elderly inpatients is related to non-elective hospital readmission.

Keywords: Frailty; combined effect; estimated glomerular filtration rate (eGFR); non-elective hospital readmission.

MeSH terms

Aged
Cohort Studies
Frail Elderly
Frailty* / epidemiology
Glomerular Filtration Rate
Humans
Inpatients
Patient Readmission
Risk Factors