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Hospital Frailty Risk Score (HFRS) Predicts Adverse Outcomes Among Hospitalized Patients with Chronic Pancreatitis

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Abstract

Introduction

The prevalence of frailty among patients with chronic pancreatitis (CP) and its impact on clinical outcomes is unclear. We report the impact of frailty on mortality, readmission rates, and healthcare utilization among patients with chronic pancreatitis in the United States.

Methods

We extracted data on patients hospitalized with a primary or secondary diagnosis of CP from the Nationwide Readmissions Database 2019. We applied a previously validated hospital frailty risk scoring system to classify CP patients into frail and non-frail on index hospitalization and compared the characteristics of frail and non-frail patients. We studied the impact of frailty on mortality, readmission, and healthcare utilization.

Results

Of 56,072 patients with CP, 40.78% of patients were classified as frail. Frail patients experienced a higher rate of unplanned and preventable hospitalizations. Almost two-thirds of frail patients were younger than 65, and one-third had no or only single comorbidity. On multivariate analysis, frailty was independently associated with two times higher mortality risk (adjusted hazard ratio [aHR], 2.05; 95% CI 1.7–2.5). Frailty was also associated with a higher risk of all-cause readmission with an aHR of 1.07; (95% CI 1.03–1.1). Frail patients experienced a longer length of stay, higher hospitalization costs, and hospitalization charges. Infectious causes were the most common cause of readmission among frail patients compared to acute pancreatitis among non-frail patients.

Conclusions

Frailty is independently associated with higher mortality, readmission rates, and healthcare utilization among patients with chronic pancreatitis in the US.

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Author information

Authors and Affiliations

  1. Department of General Internal Medicine, Brigham and Women’s Hospital, Boston, MA, USA

    Vivek Kumar & Ebrahim Barkoudah

  2. Division of Gastroenterology, Hepatology, and Endoscopy, Center for Pancreatic Disease, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA, 02115, USA

    David X. Jin, Peter Banks & Julia McNabb-Baltar

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Contributions

VK: Study concept and design; acquisition of data; analysis and interpretation of data; drafting of the manuscript. EB: Interpretation of data, Critical revision of the manuscript for important intellectual content; administrative and material support. DXJ: Interpretation of data, Critical revision of the manuscript for important intellectual content. PB: Critical revision of the manuscript for important intellectual content; study supervision. JM: Study concept and design; drafting of the manuscript; critical revision of the manuscript for important intellectual content; study supervision. All authors approved the final version to be published.

Corresponding author

Correspondence to Julia McNabb-Baltar.

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Conflict of interest

Barkoudah, Ebrahim: Dr. Barkoudah reports research support payments from the National Institutes of Health/National Heart, Lung, and Blood Institute, Bristol Myers Squibb and Janssen, payments made to Brigham and Women's Hospital for performing clinical endpoints sponsored by various entities and Advisory Board fees from Bristol Myers Squibb, Janssen, Novartis, Pfizer and Portola, and travel expenses from Alexion. McNabb-Baltar, Julia: Dr McNabb-Baltar reports research support from Healthvibe and Advisory Board fees from Nestle Health. Vivek Kumar, David X Jin, Peter Banks have no conflict of interest to declare.

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Kumar, V., Barkoudah, E., Jin, D.X. et al. Hospital Frailty Risk Score (HFRS) Predicts Adverse Outcomes Among Hospitalized Patients with Chronic Pancreatitis. Dig Dis Sci 68, 2890–2898 (2023). https://doi.org/10.1007/s10620-023-07946-w

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  • DOI: https://doi.org/10.1007/s10620-023-07946-w

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