Frailty as a predictor of mortality on admission to intermediate care

1. Frailty status upon admission to intermediate care was a strong predictor of mortality. 

Evidence Rating Level: 2 (Good) 

Frailty can be defined as a significant reduction in function and health in older adults secondary to a dysregulation in multiple physiological systems. This can have negative implications for health outcomes such as mortality and hospitalization in geriatric populations. Transitions in level of frailty can be further propagated by hospitalization; however, these specific transitions have not been specifically discussed in literature. In this prospective observational study conducted in Spain, 483 participants admitted to intermediate care (IC) facilities were assessed for degree of frailty using a frailty index (Frail-VIG). Degree of frailty was assessed 30 days prior to admission, within 48 hours following admission, at discharge, and 30 days post discharge. The results show that compared to baseline, most patients worsen in frailty after admission. As well, a higher frailty status upon admission was associated with an increased risk of mortality (HR 1.16, 95%CI 1.10-1.22). In conclusion, frailty status changed after admission to intermediate care, and this was a significant predictor for mortality. Further research exploring various factors contributing to worsening frailty amongst hospitalized individuals could be very valuable. However, this study is limited in its methodology. As the focus of this study was on individuals admitted to intermediate care, these findings cannot be generalized to all hospitalized patients. Additionally, frailty is often affected by other factors including socioeconomic status, race, gender, and psychological wellbeing. The effect of these factors on the participants in study were not discussed in detail. Nevertheless, this study provides great insight into frailty and how it can be exacerbated by hospitalizations in elderly patients, ultimately causing poor health outcomes. 

Click to read the study in BMC Geriatrics

Image: PD

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