Frailty in an Adult Acute Hospital Population: Predictors, Prevalence, and Outcomes

Area of Science:

• Geriatric Medicine
• Internal Medicine
• Clinical Gerontology

Background:

• Frailty is prevalent in older hospital inpatients, but its assessment often relies on limited data.
• Understanding the difference between pre-admission and current frailty status is crucial for accurate risk assessment.

Purpose of the Study:

• To investigate the prevalence of pre-frailty and frailty in adult hospital inpatients using comprehensive geriatric assessment (CGA).
• To examine the association between frailty and healthcare outcomes, including length of stay, mortality, and institutionalization.
• To compare pre-admission frailty status with frailty status during hospitalization.

Main Methods:

• A study was conducted on 398 adult inpatients (median age 70 years) at a university hospital, utilizing comprehensive geriatric assessment (CGA).
• Frailty and pre-frailty were assessed using the Clinical Frailty Scale.
• Statistical analyses were performed to determine the prevalence of frailty and its association with outcomes, adjusting for age and sex.

Main Results:

• The point prevalence of frailty was 30%, and pre-frailty was 14%.
• The median Clinical Frailty Scale score increased significantly from pre-admission (3/9) to review (4/9) (p < 0.001).
• Frailty was associated with prolonged length of stay (OR 1.7), one-year mortality (OR 2.1), and one-year institutionalization (OR 9), but not re-admission.

Conclusions:

• Comprehensive geriatric assessment (CGA) is vital for risk assessment in hospitalized older adults.
• Frailty is highly prevalent among hospital inpatients and is linked to adverse healthcare outcomes.
• Frailty status often worsens during hospitalization, suggesting acute illness impacts assessment; development of frailty care pathways is recommended.