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Frailty Index, Hospital Admission and Number of Days Spent in Hospital in Nursing Home Residents: Results from the INCUR Study

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The journal of nutrition, health & aging

Abstract

Objectives

To investigate the predictive capacity of an age-related deficit accumulation index (the so-called Frailty Index [FI] proposed by Rockwood) for hospital admission (HA) and number of days spent in hospital (DSH) among nursing home residents.

Design, setting and participants

Data are from a longitudinal cohort study, the Incidence of pNeumonia and related ConseqUences in nursing home Residents (INCUR), of 768 elder people (75.4% women) living in 13 nursing homes in France.

Measurements

The FI was computed taking into account 30 possible deficits at the baseline visit. Hospital admissions were defined as all urgent and involuntary admissions including unplanned readmissions. The length of stay was the total number of days spent by the resident in the hospital. Cox proportional hazard models in the presence of competing risks (death) were performed to study the relationship between the FI and HA over a 12-month follow-up. A Zero-inflated negative binomial regression was performed to study the association between the FI and DSH.

Results

Mean age of participants was 86.7 (standard deviation [SD] 6.9) years, with a mean FI of 0.37 (SD 0.11). At the end of the follow-up, 238 (30.9%) HA events were recorded. Positive associations of the FI with DSH and HA were reported (per 0.01 FI increment: age- and gender-adjusted hazard ratio 1.15, 95% confidence interval 1.020–1.297, p=0.02 and OR 1.209 (1.075–1.359, p<0.001, respectively).

Conclusions and Implications

The FI is a strong predictor of negative health-related outcomes as HA and DSH events, even with very old and complex nursing home residents.

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Acknowledgments

The INCUR project was supported by Pfizer. We thank Dr. Luca Mollo and Dr. Sedipeh Attal at Pfizer for their help and assistance. We also thank all the people who are making the INCUR project possible, in particular Dr. Laurent Demougeot, and the clinical and administrative staff of the participating nursing homes: Centre Hospitalier de Castelnaudary, De Vinci, Faux-Bourg Saint Adrien, Jean Loubès, Le Pastel, Domaine de Lasplanes, La Triade, Le Castelou, Le Garnagues, Maréchal Leclerc, Montréal, Saint Jacques, Saint Joseph.

Author information

Authors and Affiliations

  1. CHU de Guadeloupe, Université des Antilles, Guadeloupe, France

    N. Simo & Maturin Tabue-Teguo

  2. Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italy

    M. Cesari

  3. Department of Clinical Sciences and Community Health, University of Milan, Milano, Italy

    M. Cesari

  4. CH de Saint Martin, Saint-Martin, France

    H. Tchiero

  5. Gérontopôle, Centre Hospitalier Universitaire de Toulouse, INSERM UMR1027, Université de Toulouse III Paul Sabatier, Toulouse, France

    Y. Rolland, P. De Souto Barreto & B. Vellas

  6. INSERM 1219, Bordeaux Population Health Research Center, Université de Bordeaux, Bordeaux, France

    J. F. Dartigues & Maturin Tabue-Teguo

  7. Equipe LAMIA, Université des Antilles, Pointe-à-Pitre, Guadeloupe

    Maturin Tabue-Teguo

  8. CHU de Pointe-à-Pitre (Guadeloupe), Equipe LAMIA, Université des Antilles (Guadeloupe), Centre de Recherche INSERM, U1219, 146 rue Léo Saignat, 33076, Bordeaux cedex, France

    Maturin Tabue-Teguo

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  1. N. Simo
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  2. M. Cesari
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  3. H. Tchiero
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  4. Y. Rolland
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  5. P. De Souto Barreto
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  6. J. F. Dartigues
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  7. B. Vellas
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  8. Maturin Tabue-Teguo
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Corresponding author

Correspondence to Maturin Tabue-Teguo.

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Financial Disclosure: none

Conflict of Interest: Simo Nadine, Tchero Huidi, Yves Rolland, Dartigues Jean-François, Vellas Bruno, Barreto Philipe, Cesari Matteo, and Tabue-Teguo Maturin, all state no financial interest, stock, or derived direct financial benefit.

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Simo, N., Cesari, M., Tchiero, H. et al. Frailty Index, Hospital Admission and Number of Days Spent in Hospital in Nursing Home Residents: Results from the INCUR Study. J Nutr Health Aging 25, 155–159 (2021). https://doi.org/10.1007/s12603-020-1561-7

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  • DOI: https://doi.org/10.1007/s12603-020-1561-7

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