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Frailty modifications and prognostic impact in older patients admitted in acute care
Giorgio Basile1,2, Antonino Catalano3,4, Giuseppe Mandraffino5
1Unit and School of Geriatrics, Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria n. 1, Policlinico pad B, 98125, Messina, Italy. giorgio.basile@unime.it.
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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