High Hospital Frailty Risk Score (HFRS) was associated with increased 30-day in-patient mortality (aOR 1.38; 95% CI 1.35-1.42) and prolonged length of stay, but not 30-day readmissions.
Cohort (n=1,042,234)
Yes
Effect estimate: aOR 1.38 (95% CI 1.35-1.42)
BACKGROUND: The Hospital Frailty Risk Score (HFRS) has made it possible internationally to identify subgroups of patients with characteristics of frailty from routinely collected hospital data. OBJECTIVE: To externally validate the HFRS in France. DESIGN: A retrospective analysis of the French medical information database. SETTING: 743 hospitals in Metropolitan France. SUBJECTS: All patients aged 75 years or older hospitalised as an emergency in 2017 (n = 1,042,234). METHODS: The HFRS was calculated for each patient based on the index stay and hospitalisations over the preceding 2 years. Main outcome measures were 30-day in-patient mortality, length of stay (LOS) >10 days and 30-day readmissions. Mixed logistic regression models were used to investigate the association between outcomes and HFRS score. RESULTS: Patients with high HFRS risk were associated with increased risk of mortality and prolonged LOS (adjusted odds ratio aOR = 1.38 1.35-1.42 and 3.27 3.22-3.32, c-statistics = 0.676 and 0.684, respectively), while it appeared less predictive of readmissions (aOR = 1.00 0.98-1.02, c-statistic = 0.600). Model calibration was excellent. Restricting the score to data prior to index admission reduced discrimination of HFRS substantially. CONCLUSIONS: HFRS can be used in France to determine risks of 30-day in-patient mortality and prolonged LOS, but not 30-day readmissions. Trial registration: Reference ID on clinicaltrials.gov: ID: NCT03905629.
Gilbert et al. (Wed,) conducted a cohort in Frailty (n=1,042,234). Hospital Frailty Risk Score (HFRS) was evaluated on 30-day in-patient mortality, length of stay (LOS) >10 days and 30-day readmissions (aOR 1.38, 95% CI 1.35-1.42). High Hospital Frailty Risk Score (HFRS) was associated with increased 30-day in-patient mortality (aOR 1.38; 95% CI 1.35-1.42) and prolonged length of stay, but not 30-day readmissions.