FRAIL Scale: an independent predictor of in-hospital mortality among older adults.

OBJECTIVE: To screen for geriatric syndromes in older in-hospital patients and investigate their relationship with mortality. PATIENTS AND METHODS: Demographic data, comorbidities, and medical history of the patients were recorded. Anthropometric measurements were obtained at 72 hours after hospital admission. The Mini Nutritional Assessment-Short Form, strength, assistance with walking, rising from a chair, climbing stairs, and falls (SARC-F) sarcopenia screening questionnaire, Katz Activities of Daily Living scale, Lawton-Brody instrumental activities of daily living scale, the fatigue, resistance, ambulation, illness, and loss of weight (FRAIL) scale and the Eating Assessment Test-10 (EAT-10) screening test were used to assess geriatric syndromes. All patients were evaluated for delirium, pain, falls, polypharmacy, sleep disorders, incontinence, and pressure injury by the same researcher. RESULTS: A total of 85 patients were included in the study. The mean age was 75±7 years (range: 66-97). During hospital follow-up, 15.3% (n=13) of the patients died and 84.7% (n=72) were discharged. The median length of stay was 19 days (range: 3-126 days). In the multivariate analysis, frailty (hazard ratio: 2.67, 95% CI: 1.41-5.06, p=0.003) was found to be associated with in-hospital mortality. CONCLUSIONS: Frailty is an independent risk factor for in-hospital mortality in older adults.

The effect of frailty in older community-dwelling outpatients with atrial fibrillation: a new score HAS-BLED-F (rail).

OBJECTIVE: This study aims to determine the effect of frailty on thromboembolic events (TEE) and bleeding in older patients with non-valvular atrial fibrillation (AF). PATIENTS AND METHODS: Patients aged ≥65 years who were diagnosed as having non-valvular AF in a geriatric outpatient clinic between June 2015 and February 2021 were included in the study. Frailty, the risk of thrombosis secondary to AF, and the risk of bleeding as a complication of AF treatment were evaluated using the FRAIL scale, and CHA2DS2-VASc and HAS-BLED scores, respectively. RESULTS: Out of 83 patients included in the study, 72.3% were frail and 21.7% were pre-frail. TEE was observed in 14.5% (n=12) and bleeding was observed in 25.3% (n=21) of the patients. A total of 21 (25.3%) patients had a history of bleeding. There was no difference between the normal, pre-frail, and frail groups in terms of TEE and bleeding history (p=0.112 and p=0.571, respectively). In multivariate analysis, mortality decreased with the use of apixaban; frailty and malnutrition were found to increase mortality (p=0.014, p=0.023, and p=0.020, respectively). HAS-BLED-F score was obtained as a result of the sum of the patients' HAS-BLED and FRAIL scores to predict the bleeding risk. A HAS-BLED-F score of ≥6 predicted the risk of bleeding with 90.5% sensitivity and 40.3% specificity. CONCLUSIONS: Frailty is not associated with a statistically significant increase in the risk of thromboembolic events or bleeding in patients with non-valvular AF. HAS-BLED-F score can be used to better predict the risk of bleeding in frail patients.