The Hospital Frailty Risk Score Predicts Poor Prognoses in Middle-Aged and Older Patients With Acute Pancreatitis: A Nationwide Retrospective Cohort Study in Japan

Pancreas. 2023 Apr 1;52(4):e249-e255. doi: 10.1097/MPA.0000000000002246. Epub 2023 Sep 21.

Abstract

Objectives: Frailty risk may be associated with poor prognoses in acute pancreatitis patients. However, this has not been shown with adjustments for prognosis-related factors. This study aimed to determine whether frailty risk is associated with poor prognoses in acute pancreatitis patients, even after adjusting for prognosis-related factors.

Methods: The study included 7001 middle-aged and older patients (mean age, 66.2 ± 14.5 years, 65.3% male) 40 years or older who were registered in a Japanese nationwide database. Frailty risk was defined as a Hospital Frailty Risk Score ≥5 points. Outcomes were 30-day and in-hospital mortality, length of stay, and 30-day readmission rate.

Results: Frailty risk was independently positively associated with 30-day mortality (odds ratio [OR], 1.847; 95% confidence interval [CI], 1.118-3.051) and in-hospital mortality (OR, 2.504; 95% CI, 1.677-3.739) after adjustment for acute pancreatitis severity and patient characteristics. In addition, frailty risk was positively associated with a longer length of stay (coefficient, 11.393; 95% CI, 9.631-13.154). However, no association was found between frailty risk and the 30-day readmission rate (OR, 1.092; 95% CI, 0.793-1.504).

Conclusions: Our findings highlight the importance of rapid and automated frailty risk assessment using the Hospital Frailty Risk Score for the early identification of high-risk acute pancreatitis patients.

MeSH terms

  • Acute Disease
  • Aged
  • Aged, 80 and over
  • Female
  • Frailty* / diagnosis
  • Hospital Mortality
  • Hospitals
  • Humans
  • Japan / epidemiology
  • Length of Stay
  • Male
  • Middle Aged
  • Pancreatitis* / diagnosis
  • Prognosis
  • Retrospective Studies
  • Risk Factors