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Using the Hospital Frailty Risk Score to Predict In-Hospital Mortality Across All Ages.

Huda Kutrani1, Jim Briggs1, David Prytherch1

  • 1Centre for Healthcare Modelling and Informatics, University of Portsmouth, Portsmouth, UK.

Studies in Health Technology and Informatics
|May 17, 2025
PubMed
Summary
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The Hospital Frailty Risk Score (HFRS) effectively predicts in-hospital mortality in adult patients, outperforming the Charlson Comorbidity Index (CCI). Combining both scores offers the highest accuracy for predicting patient outcomes.

Area of Science:

  • Gerontology and Geriatric Medicine
  • Health Services Research
  • Clinical Epidemiology

Background:

  • Frailty is a significant predictor of adverse outcomes in hospitalized adults.
  • Existing comorbidity indices may not fully capture frailty-related mortality risk.
  • The Hospital Frailty Risk Score (HFRS) is a validated tool for assessing frailty in hospital settings.

Purpose of the Study:

  • To investigate the association between the Hospital Frailty Risk Score (HFRS) and in-hospital mortality.
  • To compare the predictive performance of HFRS against the Charlson Comorbidity Index (CCI).
  • To evaluate the combined predictive accuracy of HFRS and CCI for mortality.

Main Methods:

  • Retrospective cohort analysis of adult patients (≥16 years) admitted between 2010-2019.
Keywords:
AgeFrailtyHospital Frailty Risk ScoreIn-hospital mortality

Related Experiment Videos

  • HFRS calculated for patients with prior hospitalizations within two years.
  • Logistic regression models used to assess mortality prediction across nine periods; AUROC curves compared HFRS and CCI.
  • Main Results:

    • The proportion of patients with intermediate or high frailty risk increased with longer mortality prediction periods.
    • HFRS models demonstrated superior predictive accuracy (AUROC: 0.782-0.829) compared to CCI (AUROC: 0.690-0.708).
    • The combination of HFRS and CCI yielded the highest predictive accuracy for in-hospital mortality.

    Conclusions:

    • HFRS is an effective and robust predictor of in-hospital mortality across all adult age groups.
    • HFRS surpasses the predictive capability of the CCI for mortality risk assessment.
    • Combining HFRS with CCI enhances the accuracy of in-hospital mortality prediction.