Development of a population-level frfailty index using Quebec administrative data: a Canadian retrospective study

Area of Science:

• Gerontology
• Critical Care Medicine
• Health Services Research

Background:

• Frailty is a significant predictor of adverse outcomes in intensive care unit (ICU) patients.
• Existing frailty assessment tools may not be readily applicable to large-scale health administrative datasets.
• Identifying frail ICU patients is crucial for targeted interventions and resource allocation.

Purpose of the Study:

• To develop and validate a frailty index using the Quebec health administrative dataset.
• To identify frail patients admitted to the ICU.
• To investigate the association between frailty and ICU patient outcomes, specifically in-hospital mortality.

Main Methods:

• Retrospective observational study utilizing administrative data from CIUSSS-EMTL in Montreal, Quebec.
• Cohort creation through data linkage of hospital admission, homecare, and medication databases.
• Development of a 30-item frailty index based on Rockwood guidelines, applied to patients aged 18+ with index ICU admission (2016-2023).

Main Results:

• A 30-item frailty index was successfully developed and applied to 10,849 ICU patients.
• 20% of the patient cohort were identified as frail, exhibiting older age and higher rates of dialysis and mechanical ventilation.
• Frailty was significantly associated with an increased risk of in-hospital mortality (adjusted odds ratio: 1.464).

Conclusions:

• A multidimensional 30-item frailty index was created from health administrative data.
• A strong correlation between frailty and mortality in ICU patients was demonstrated.
• This index can aid in identifying at-risk populations and evaluating care processes within ICUs.