National Norms for Hospital Frailty Risk Score Among Hospitalized Adults in the USA

Area of Science:

• Gerontology
• Health Services Research
• Clinical Informatics

Background:

• Frailty in hospitalized patients elevates risks of disability and mortality.
• Current frailty screening is inconsistent in acute care due to complexity and resource demands.
• Routine data collection offers a viable method for widespread inpatient frailty assessment.

Purpose of the Study:

• To establish normative values for the Hospital Frailty Risk Score (HFRS) in US adult inpatients.
• To stratify HFRS norms by age, sex, and race.
• To provide a benchmark for inpatient frailty risk assessment.

Main Methods:

• Retrospective cross-sectional analysis using the 2018 National Inpatient Sample (NIS) database.
• Inclusion of US adult inpatients aged 18 and older, with a focus on those 45 and older.
• Utilized the validated Hospital Frailty Risk Score (HFRS), calculated from ICD-10 codes.

Main Results:

• Hospital Frailty Risk Score (HFRS) significantly increased with age across all demographic groups (p < 0.001).
• In patients 65 and older, HFRS means and medians were similar between sexes.
• Black inpatients exhibited higher frailty risk compared to other racial groups, with similar risk observed in Asian/Pacific Islander inpatients aged 90+.

Conclusions:

• US national norms for HFRS serve as a standardized tool for comparative frailty risk assessment.
• These norms enable comparisons within clinical and research inpatient populations against typical values for age, sex, and race.
• Facilitates better understanding and management of frailty in hospitalized individuals.