Comparing three different measures of frailty in medical inpatients: Multicenter prospective cohort study examining 30-day risk of readmission or death.
J Hosp Med
; 11(8): 556-62, 2016 08.
Article
em En
| MEDLINE
| ID: mdl-27187268
ABSTRACT
BACKGROUND:
Multiple tools are used to identify frailty.OBJECTIVE:
To compare the global Clinical Frailty Scale (CFS) with more objective phenotypic tools (modified Fried score and the Timed Up and Go Test [TUGT]).DESIGN:
Prospective cohort study.SETTING:
General medical wards in Edmonton, Canada.PARTICIPANTS:
Adults being discharged back to the community. MEASUREMENTS All frailty assessments were done within 24 hours of discharge. Patients were classified as frail if they scored ≥5 on the CFS and/or ≥3 on the modified Fried score, and/or had reduced mobility (>20 seconds on the TUGT). The main outcome was readmission or death within 30 days.RESULTS:
Of 495 patients, 211 (43%) were frail according to at least 1 assessment, 46 (9%) met all 3 frailty definitions, and 17% died or were readmitted to the hospital within 30 days. Although patients classified as frail on the CFS exhibited significantly higher 30-day readmission/death rates (23% vs 14% for not frail, P = 0.005; 28% vs. 12% in the elderly, P < 0.001), even after adjusting for age and sex (adjusted odds ratio [aOR] 2.02, 95% confidence interval [CI] 1.19-3.41 for all adults; aOR 3.20, 95% CI 1.55-6.60 for the elderly), patients meeting either of the phenotypic definitions for frailty but not the CFS definition were not at higher risk of 30-day readmission/death (aOR 0.87, 95% CI 0.34-2.19 for all adults and aOR 1.41, 95% CI 0.72-2.78 for the elderly).CONCLUSIONS:
Frailty has a significant impact on postdischarge outcomes, and the CFS is the most useful of the frequently used frailty tools for predicting poor outcomes after discharge. Journal of Hospital Medicine 2016;11556-562. © 2016 Society of Hospital Medicine.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Alta do Paciente
/
Readmissão do Paciente
/
Mortalidade
/
Idoso Fragilizado
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
J Hosp Med
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
Canadá