The Maastricht Frailty Screening Tool for Hospitalised Patients (MFST-HP) to Identify Non-Frail Patients

The Maastricht frailty screening tool for hospitalised patients (MFST-HP) is a frailty screening tool that is fully integrated in the nursing assessment at admission. This study aims to determine the predictive value of the MFST-HP for the health outcomes length of hospital stay, discharge destination, readmission and mortality.

Data of 2691 hospitalised patients (70+), admitted between 01-01-2013 and 31-12-2013, were included in the study. The predictive value of the MFST-HP was analysed by means of receiver operating characteristics curves. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for different MFST-HP cut-off scores were examined.

Mean age of the population was 78.9 years (SD 6.4) and their average length of stay was 10.2 days (SD 9.7). Nearly 75.0% of the patients were discharged to their home and around. Approximately 25% of the patients were readmitted within 120 days. Mortality rates were 4.3% and 9.5% (within 30 or 120 days postdischarge, respectively). The area under the curve was moderate and varied from 0.50 to 0.69 for the different outcomes. As a result of high values on negative predictive value (between 73.5% and 96.7%) the MFST-HP is able to rule out a large proportion of non-frail patients. In this study 84% of the patients had a MFST-HP score of ≥ 6, suggested as most favourable cut off.

The MFST-HP seems to operate more strongly as a non-frailty indicator than as a frailty indicator and may in this respect help professionals to decide upon subsequent care. The MFST-HP is able to rule out 84% of the non-frail population in this study. The remaining 16% need to be assessed by means of a comprehensive geriatric assessment or rapid geriatric assessment, to gain more insight in the level of vulnerability in the frail-group.