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Combined use of the Clinical Frailty Scale and laboratory tests in acutely hospitalized older patients

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Abstract

Aims

To evaluate the Clinical Frailty Scale (CFS) and a Frailty Index based on laboratory tests (FI-lab) in terms of what each assesses about frailty and to determine the appropriateness of combined use of these two frailty scales.

Methods

This was a prospective observational cohort study in an acute geriatric ward of a university hospital. The FI-lab is the proportion of laboratory parameters that yield abnormal results from a total of 23. The FI-lab and CFS were assessed at admission. Data on activities of daily living (ADL), cognition, geriatric syndromes, and comorbidities were also collected. Main outcomes were in-hospital mortality and 90-day mortality after admission.

Results

In total, 378 inpatients (mean age 85.2 ± 5.8 years, 59.3% female) were enrolled. ADL and cognition correlated strongly with the CFS (Spearman’s |r|> 0.60) but weakly with the FI-lab (|r|< 0.30). Both the CFS and FI-lab correlated weakly with geriatric syndromes and comorbidities (|r|< 0.40). The correlation between the CFS and FI-lab was also weak (r = 0.28). The CFS and FI-lab were independently associated with in-hospital mortality and 90-day mortality after admission. The Akaike information criterion was lower for models using both the CFS and FI-lab than for models using either tool alone.

Conclusions

The CFS and FI-lab each reflected only some of the aspects of frailty in acutely hospitalized older patients. The model fit was better when the two frailty scales were used together to assess the mortality risk than when either was used alone.

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Data availability

Participants of this study did not agree for their data to be shared publicly, so supporting data is not available.

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Acknowledgements

The authors would like to thank the participants and staff members who helped with this study.

Funding

This work was supported by JSPS KAKENHI (Grant No. JP21H02826), and THE HORI SCIENCES AND ARTS FOUNDATION (Grant No. 31–1-031).

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Authors and Affiliations

  1. Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, Aichi, 466-8560, Japan

    Hirotaka Nakashima, Masaaki Nagae, Hitoshi Komiya, Chisato Fujisawa, Kazuhisa Watanabe, Yosuke Yamada, Tomihiko Tajima, Shuzo Miyahara, Tomomichi Sakai & Hiroyuki Umegaki

Authors
  1. Hirotaka Nakashima
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  2. Masaaki Nagae
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  3. Hitoshi Komiya
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  4. Chisato Fujisawa
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  5. Kazuhisa Watanabe
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  6. Yosuke Yamada
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  7. Tomihiko Tajima
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  8. Shuzo Miyahara
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  9. Tomomichi Sakai
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  10. Hiroyuki Umegaki
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Contributions

HN: conceptualization, methodology, software, formal analysis, investigation, data curation, writing—original draft, visualization, and project administration. MN: investigation, data curation, writing—review & editing, and project administration. HK: investigation, and writing—review & editing. CF: investigation, and writing—review & editing. KW: investigation, and writing—review & editing. YY: investigation, and writing—review & editing. TT: investigation, and writing—review & editing. SM: investigation and writing—review & editing. TS: investigation and writing—review & editing. HU: conceptualization, validation, resources, writing—review & editing, supervision, project administration, and funding acquisition.

Corresponding author

Correspondence to Hirotaka Nakashima.

Ethics declarations

Conflict of interest

The authors declare there are no conflicts of interest. The sponsors played no role.

Ethical approval

The study protocol was approved by the Ethics Committee of Nagoya University Graduate School of Medicine (Approval No. 2019–0260) and conducted according to the principles of the Declaration of Helsinki and its amendments.

Consent to participate

Written informed consent was obtained from all patients or a family member if necessary.

Human and animal rights

The present study is an observational cohort study with human subjects. All methods in this study were conducted in accordance with the amended Declaration of Helsinki.

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Nakashima, H., Nagae, M., Komiya, H. et al. Combined use of the Clinical Frailty Scale and laboratory tests in acutely hospitalized older patients. Aging Clin Exp Res 35, 1927–1935 (2023). https://doi.org/10.1007/s40520-023-02477-w

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  • DOI: https://doi.org/10.1007/s40520-023-02477-w

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