| Title | Frailty status at admission to hospital predicts multiple adverse outcomes |
| Publication Type | Journal Article |
| Year of Publication | 2017 |
| Authors | Hubbard RE, Peel NM, Samanta M, Gray L.eonardC, Mitnitski A, Rockwood K |
| Journal | Age Ageing |
| Volume | 46 |
| Issue | 5 |
| Pagination | 801-806 |
| Date Published | Sep 1 |
| ISBN Number | 0002-0729 |
| Accession Number | 28531254 |
| Keywords | *Frail Elderly, *Patient Admission, Accidental Falls, Age Factors, Aged, aging, Area Under Curve, Australia/epidemiology, delirium, Delirium/epidemiology, Electronic Health Records, Female, frail older people, Frailty/*diagnosis/mortality/therapy, Geriatric Assessment/*methods, Hospital Mortality, Humans, Incidence, Inpatients, length of stay, Logistic Models, Male, Odds Ratio, Patient Discharge, Predictive Value of Tests, Pressure Ulcer/epidemiology, Prospective Studies, Reproducibility of Results, Risk Assessment, Risk Factors, ROC Curve |
| Abstract | Aims: frailty is proposed as a summative measure of health status and marker of individual vulnerability. We aimed to investigate the discriminative capacity of a frailty index (FI) derived from interRAI Comprehensive Geriatric Assessment for Acute Care (AC) in relation to multiple adverse inpatient outcomes. Methods: in this prospective cohort study, an FI was derived for 1,418 patients >/=70 years across 11 hospitals in Australia. The interRAI-AC was administered at admission and discharge by trained nurses, who also screened patients daily for geriatric syndromes. Results: in adjusted logistic regression models an increase of 0.1 in FI was significantly associated with increased likelihood of length of stay >28 days (odds ratio [OR]: 1.29 [1.10-1.52]), new discharge to residential aged care (OR: 1.31 [1.10-1.57]), in-hospital falls (OR: 1.29 [1.10-1.50]), delirium (OR: 2.34 [2.08-2.63]), pressure ulcer incidence (OR: 1.51 [1.23-1.87]) and inpatient mortality (OR: 2.01 [1.66-2.42]). For each of these adverse outcomes, the cut-point at which optimal sensitivity and specificity occurred was for an FI > 0.40. Specificity was higher than sensitivity with positive predictive values of 7-52% and negative predictive values of 88-98%. FI-AC was not significantly associated with readmissions to hospital. Conclusions: the interRAI-AC can be used to derive a single score that predicts multiple adverse outcomes in older inpatients. A score of |
| DOI | 10.1093/ageing/afx081 |
| Link | |
| Alternate Journal | Age and ageing |
