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Using Existing Clinical Data to Measure Older Adult Inpatients' Frailty at Admission and Discharge: Hospital Patient
Boris Wernli1, Henk Verloo2, Armin von Gunten3
1Swiss Centre of Expertise in the Social Sciences (FORS), Lausanne, Switzerland.
JMIR Aging
|October 28, 2024
Summary
A new electronic frailty measurement tool (e-Frail-CH) effectively identifies frailty in hospitalized older adults using routine data. The tool showed higher frailty scores at discharge, aiding clinical alerts and interventions.
Area of Science:
- Geriatric Medicine
- Health Informatics
- Public Health
Background:
- Frailty is a common geriatric syndrome in hospitalized older adults.
- Electronic frailty measurement tools are underutilized in acute care settings.
- A data-driven instrument could improve frailty identification and management.
Purpose of the Study:
- To develop and validate a data-driven electronic frailty measurement instrument for older inpatients.
- To utilize routinely collected hospital admission and discharge data.
- To create a clinical alert system for frailty.
Main Methods:
- Retrospective study of 53,690 hospitalizations (≥65 years) from 2015-2017.
- Developed e-Frail-CH instrument inspired by the Edmonton Frailty Scale.
- Applied a 2-step hierarchical cluster procedure for score computation.
Main Results:
- Mean patient age was 78.4 years; 52.18% were women.
- Frailty prevalence was 42.02% at admission and 48.23% at discharge.
- e-Frail-CH showed high sensitivity (0.82) and specificity (0.88), AUC 0.85; strong correlation with FIM (r=-0.844).
Conclusions:
- Validated an electronic frailty measurement instrument using routine hospitalization data.
- Observed a higher mean e-Frail-CH score at discharge, indicating increased frailty.
- Routine e-Frail-CH scoring can provide clinical alerts and guide interventions for older adults.
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