Abstract
BackgroundThe prevalence and significance of frailty are seldom studied in hospitalized patients. Aim of this study is to evaluate the prevalence of frailty and to determine the extent that frailty predicts delirium, falls and mortality in hospitalized older patients.MethodsIn a prospective study of 220 older patients, frailty was determined using the Cardiovascular Health Study (CHS) and the Study of Osteoporotic Fracture (SOF) frailty index. Patients were classified as nonfrail, prefrail, and frail, according to the specific criteria. Covariates included clinical and laboratory parameters. Outcome variables included in hospital delirium and falls, and 6-month mortality.ResultsThe CHS frailty index was available in all 220 patients, of which 1.5% were classified as being nonfrail, 58.5% as prefrail, and 40% as frail. The SOF frailty index was available in 204 patients, of which 16% were classified as being nonfrail, 51.5% as prefrail, and 32.5% as frail. Frailty, as identified by the CHS and SOF indexes, was a significant risk factor for 6-month mortality. However, after adjustment for multiple risk factors, frailty remained a strong independent risk factor only for the model with the CHS index (OR 4.7, 95% CI 1.7-12.8). Frailty (identified by CHS and SOF indexes) was not found to be a risk factor for delirium or falls.ConclusionsFrailty, as measured by the CHS index, is an independent risk factor for 6-month mortality. The CHS and the SOF indexes have limited value as risk assessment tools for specific geriatric syndromes (e.g., falls and delirium) in hospitalized older patients.
Highlights
The prevalence and significance of frailty are seldom studied in hospitalized patients
Frailty in older subjects has been defined as a state of decreased functional reserve and resistance to stressors that are associated with a high prevalence of adverse health outcomes, such as poor functional and cognitive status, falls, institutionalization, and mortality [1,2]
The aim of this study was to evaluate the prevalence of frailty in hospitalized older patients, as determined by the Cardiovascular Health Study (CHS) and Study of Osteoporotic Fracture (SOF) indexes, and to determine the extent that frailty can predict delirium and falls during hospitalization, and mortality 6 months after discharge
Summary
The prevalence and significance of frailty are seldom studied in hospitalized patients. Aim of this study is to evaluate the prevalence of frailty and to determine the extent that frailty predicts delirium, falls and mortality in hospitalized older patients. Frailty in older subjects has been defined as a state of decreased functional reserve and resistance to stressors that are associated with a high prevalence of adverse health outcomes, such as poor functional and cognitive status, falls, institutionalization, and mortality [1,2]. The prevalence of frailty varies widely depending on its definitions, patient selection, and socioeconomic factors like education. In a European study involving 10 different countries, frailty prevalence was 4.1% in non-hospitalized subjects aged 50–65 years and 17% in subjects aged 65 years and older [4]. The frailty prevalence varied from 27% to 80% [6,7,8]
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