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Prognostic Performance of the Clinical Frailty Scale for Predicting 30-Day Mortality in Hospitalised Indonesian Older
Ressy Hastopraja1, Dina Aprillia Ariestine2, Ariantho Sidasuha Purba3
1Department of Internal Medicine, Universitas Sumatera Utara, Medan, Indonesia. rhastopraja@gmail.com.
Background:
Frailty is common among hospitalized elderly patients, with prevalence rates ranging from 27% to 80%. Frail individuals have a higher risk of mortality than non-frail individuals do. The Clinical Frailty Scale (CFS), developed by the Canadian Study of Health and Aging (CSHA), is a widely used tool for assessing frailty and clinical outcomes in older adults. This study aimed to evaluate the prognostic performance of the CFS in predicting 30-day mortality among elderly inpatients.
Methods:
This prospective cohort study included patients aged ≥ 60 years admitted to the Haji Adam Malik Central General Hospital in Medan, Indonesia. Discrimination and calibration of the CFS were evaluated using the ROC curve and Hosmer-Lemeshow tests, while logistic regression identified factors independently associated with mortality. Discrimination and calibration of the CFS were evaluated using the ROC curve and Hosmer-Lemeshow tests, while logistic regression identified factors independently associated with mortality.
Results:
Among 120 patients, the 30-day mortality rate was 43.3%. The Hosmer-Lemeshow test indicated good calibration (p = 0.661), and ROC curve analysis showed good discrimination (AUC = 83.2%, 95% CI 76%-90.4%). Multivariate analysis identified the C-reactive protein level, CFS score, and nutritional status as independent predictors of 30-day mortality.
Conclusion:
Clinical Frailty Scale (CFS) demonstrates good prognostic performance for predicting 30-day mortality among elderly inpatients, with elevated CRP, higher CFS scores, and malnutrition serving as independent predictors of death.
