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Frailty in Hospitalized Older Adults: Comparing Different Frailty Measures in Predicting Short- and Long-term Patient Outcomes

التفاصيل البيبلوغرافية
العنوان: Frailty in Hospitalized Older Adults: Comparing Different Frailty Measures in Predicting Short- and Long-term Patient Outcomes
المؤلفون: Yew Yoong Ding, Lynn Wu, Esther Ho, Wee Shiong Lim, Mark Y. Chan, Laura Tay, Edward Chong, Jewel Baldevarona-Llego
المصدر: Journal of the American Medical Directors Association. 19(5)
سنة النشر: 2017
مصطلحات موضوعية: Gerontology, Male, medicine.medical_specialty, Comorbidity, Logistic regression, Risk Assessment, Sensitivity and Specificity, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Acute care, Severity of illness, Risk of mortality, Medicine, Humans, 030212 general & internal medicine, Hospital Mortality, Prospective cohort study, Geriatric Assessment, General Nursing, Geriatrics, Aged, 80 and over, Singapore, Frailty, business.industry, Health Policy, Gold standard, Institutionalization, General Medicine, Length of Stay, Confidence interval, Hospitalization, Female, Geriatrics and Gerontology, business, human activities, 030217 neurology & neurosurgery
الوصف: Data for the assessment of frailty in acutely ill hospitalized older adults remains limited. Using the Frailty Index (FI) as "gold standard," we compared (1) the diagnostic performance of 3 frailty measures (FRAIL, Clinical Frailty Scale [CFS], and Tilburg Frailty Indicator [TFI]) in identifying frailty, and (2) their ability to predict negative outcomes at 12 months after enrollment.Prospective cohort study.We recruited 210 patients (mean age 89.4 ± 4.6 years, 69.5% female), admitted to the Department of Geriatric Medicine in a 1300-bed tertiary hospital.Premorbid frailty status was determined. Data on comorbidities, severity of illness, functional status, and cognitive status were gathered. We compared area under receiver operator characteristic curves (AUC) for each frailty measure against the reference FI. Multiple logistic regression was used to examine the independent association between frailty and the outcomes of interest.Frailty prevalence estimates were 87.1% (FI), 81.0% (CFS), 80.0% (TFI), and 50.0% (FRAIL). AUC against FI ranged from 0.81 (95% confidence interval [CI] 0.72-0.90: FRAIL) to 0.91 (95% CI 0.87-0.95: CFS). Only FRAIL was associated with higher in-hospital mortality (6.7% vs 1.0%, P = .031). FRAIL and CFS were significantly associated with increased length of hospitalization (10 [6.0-17.5] vs 8 [5.0-14.0] days, P = .043 and 9 [5.0-17.0] vs 7 [4.25-11.75] days, P = .036, respectively). CFS and FI were highly associated with mortality at 12-month (CFS, frail vs nonfrail: 32.9% vs 2.5%, P .001, and FI, frail vs nonfrail: 30.6% vs 3.7%, P .001). CFS also conferred the greatest risk of 12-month mortality (odds ratio [OR] 5.78, 95% CI 3.19-10.48, P .001) and composite outcomes of institutionalization and/or mortality (OR 3.69, 95% CI 2.31-5.88, P .001), adjusted for age, sex, and severity of illness.Our study affirms the utility of frailty assessment tools among older persons in acute care. FRAIL conferred highest risk of in-hospital mortality. However, CFS had greatest risk of mortality and institutionalization within 12 months.
تدمد: 1538-9375
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::76694d483626512b01970872826930f3
https://pubmed.ncbi.nlm.nih.gov/29153536
حقوق: CLOSED
رقم الأكسشن: edsair.doi.dedup.....76694d483626512b01970872826930f3
قاعدة البيانات: OpenAIRE
الوصف
تدمد:15389375