Frailty modifications and prognostic impact in older patients admitted in acute care

Aging Clin Exp Res. 2019 Jan;31(1):151-155. doi: 10.1007/s40520-018-0989-7. Epub 2018 Jun 26.

Abstract

Background: Frailty is a predictor of adverse outcomes in older subjects.

Aims: The aims of this study are to (1) measure the frailty status and its changes occurring during the hospital stay, (2) determine the relationships among frailty and adverse outcomes.

Methods: Frailty was assessed using a 46-item Frailty Index (FI) in 156 patients admitted to an Acute Geriatric Medicine Unit. The FI was calculated within 24 h from the hospital admission (aFI) and at his/her discharge (dFI). Patients were followed up to 12 months after the hospital discharge.

Results: A statistically significant difference was reported between the aFI (0.31, IQR 0.19-0.44) and the dFI (0.29, IQR 0.19-0.40; p = 0.04). The aFI was directly associated with the risk of in-hospital death (OR = 5.9; 95% CI 2.0-17.5; p = 0.001), 1 year mortality (OR = 5.5, 95% CI 2.4-12.7, p < 0.001) and re-hospitalization (OR = 6.3, 95% CI 2.2-17.9, p = 0.03).

Conclusion: Frailty is a strong predictor of negative endpoints in hospitalized older persons.

Discussion: Frailty assessment from routinely collected clinical data may provide important insights about the biological status of the individual and promote the personalization of care.

Keywords: Elderly; Frailty; Hospitalization; Length of stay; Mortality.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Frail Elderly / statistics & numerical data*
  • Frailty / diagnosis*
  • Frailty / mortality
  • Geriatric Assessment / methods*
  • Hospital Mortality
  • Hospitalization / statistics & numerical data
  • Humans
  • Length of Stay
  • Male
  • Prognosis