Construction and validation of oral frailty risk assessment model in elderly hospitalized patients

To analyze the influencing factors of oral frailty in Elderly hospitalized patients, develop a nomogram-based risk assessment model, and validate its assessment performance. A total of 664 Elderly patients were selected from a tertiary hospital in Tianjin between January 2024 and October 2024. Data were collected using a general information questionnaire, the Oral Frailty Screening Scale, the Frailty Scale, the Social Support Rating Scale, the Mini-Nutritional Assessment Short Form, and the Pittsburgh Sleep Quality Index. Patients were categorized based on oral frailty severity. Chi-square tests and logistic regression analyses were used to identify influencing factors. Nomogram-based assessment tool was constructed using R software (version 4.2.2). Model performance was evaluated using the Hosmer-Lemeshow test and the area under the receiver operating characteristic (ROC) curve. Internal validation was performed via bootstrap resampling, and calibration curves were generated. Clinical decision curve analysis was also conducted. The prevalence of oral frailty among Elderly patients was 26.6%. Multivariate analysis identified age, number missing of teeth, denture usage, social support score, gender, residential environment, subjective masticatory difficulty, xerostomia, dietary preferences, frailty severity, and nutritional status as independent risk factors (all P < 0.05). The nomogram model demonstrated an area under the curve (AUC) of 0.878 (95% CI: 0.845–0.913, P < 0.001), with sensitivity and specificity of 0.800 and 0.806, respectively. The Hosmer-Lemeshow χ² value was 10.966 (P = 0.372). In the internal validation cohort, the AUC was 0.918 (95% CI: 0.876–0.959, P < 0.001), with sensitivity and specificity of 0.842 and 0.849, respectively (Hosmer-Lemeshow χ² = 6.747, P = 0.881). Decision curve analysis indicated significant net clinical benefits within specific threshold ranges, supporting the model’s clinical utility. The prevalence of oral frailty in Elderly hospitalized patients is notably high and influenced by multiple factors, including age, dental status, social support, gender, environmental factors, masticatory function, and nutritional status. the risk assessment model has good discriminative value for identifying oral frailty in hospitalized elderly patients.