The Hospital Frailty Risk Score-outcomes in specialised services

Area of Science:

• Geriatric Medicine
• Health Services Research
• Clinical Epidemiology

Background:

• Frailty assessment is crucial for risk stratification in older adults.
• Current frailty assessment lacks standardization across specialized healthcare services.
• The Hospital Frailty Risk Score (HFRS) offers a potential standardized approach.

Purpose of the Study:

• To evaluate the applicability of the Hospital Frailty Risk Score (HFRS) in English specialized services.
• To assess the association between HFRS-defined frailty and patient outcomes.
• To determine if HFRS can describe outcomes for older individuals in specialized care.

Main Methods:

• Retrospective cohort study using the Secondary Uses Service (SUS) electronic database.
• Inclusion of individuals aged 75 years or older admitted between April 2017 and March 2018.
• Risk stratification into mild, moderate, and severe frailty using HFRS, with analysis of length of stay, readmission rates, mortality, and treatment complications.

Main Results:

• The HFRS successfully stratified over 98% of the study population.
• Frailty distribution: approximately one-third mild, one-third moderate, and one-quarter severe.
• Increased frailty severity correlated with longer hospital stays, more hospital days post-intervention, and higher in-hospital mortality.
• Severe frailty was a strong predictor of 30-month mortality (25-40% across specialties).

Conclusions:

• This study represents the first national application of HFRS to assess outcomes in specialized care for older adults.
• HFRS can effectively describe service outcomes and mortality for older patients undergoing specialized interventions.
• Findings support HFRS utilization for identifying patients needing holistic assessment, aiding prognostication, and informing commissioning and service planning.