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

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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.

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Funding

This research did not receive any specific Grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors

Corresponding author

Correspondence to Giorgio Basile.

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Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

The study was approved by the Ethics Committee of the University of Messina (prot. number 19/17). The study has been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

For this type of study formal consent is not required.

Appendix

Appendix

See Table 3.

Table 3 Variables and cut points considered in creating the Frailty Index

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Basile, G., Catalano, A., Mandraffino, G. et al. Frailty modifications and prognostic impact in older patients admitted in acute care. Aging Clin Exp Res 31, 151–155 (2019). https://doi.org/10.1007/s40520-018-0989-7

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  • DOI: https://doi.org/10.1007/s40520-018-0989-7

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