Historical Records of the Far East on the Great Patriotic War

BACKGROUND: Frailty assessment is crucial for predicting outcomes in acute care settings; however, its application remains challenging. Therefore, this study aims to evaluate and compare two electronic medical record-based tools-the Canadian Institute for Health Information Hospital Frailty Risk Measure (CIHI-HFRM) and the United Kingdom Hospital Frailty Risk Score (UK-HFRS)-in older patients requiring urgent admission. METHODS: In this retrospective cohort study, we analyzed 35,564 patients aged 65 or older from the MIMIC-IV 2.0 database. Frailty was assessed using CIHI-HFRM and UK-HFRS. Primary outcomes included in-hospital mortality, one-year post-discharge mortality, post-discharge care needs, timely hospital discharge, and one-year readmission rates. Logistic regression, Cox regression, and competing risk models were used for analysis. RESULTS: The CIHI-HFRM and UK-HFRS were significantly associated with in-hospital mortality [odds ratio (OR) per point: CIHI-HFRM 1.10 (95% confidence interval (CI) 1.07-1.13); UK-HFRS 1.06 (95% CI 1.05-1.07)] and one-year post-discharge mortality [hazard ratio (HR) per point: CIHI-HFRM 1.08 (95% CI 1.06-1.09); UK-HFRS 1.05 (95% CI 1.04-1.05)]. Both measures were associated with prolonged hospital stays and post-discharge care needs, while only CIHI-HFRM was linked to one-year readmission risk. CONCLUSION: The CIHI-HFRM and UK-HFRS effectively stratify adverse outcomes risk in older patients requiring urgent admission. They may be considered alongside traditional measures as part of a pragmatic multimodal pathway, which represents a potential direction for clinical application.