Highlights
- •Frailty is a state of late-life characterized by increased vulnerability to stressors and is associated with poor health outcomes
- •Different definitions of frailty have been proposed to help different stakeholders. The Frailty Index (FI) proposed by Rockwood and Mitnitski is one of the most promising tools for measuring frailty.
- •It is defined following a arithmetical model aimed at capturing the age-related accumulation of health deficits concerning different domains, such as cognition and mood, organ diseases, functional autonomy.
- •In this study the FI confirms its predictive value for in-hospital and short term mortality even when it is applied to a large sample of hospitalized older patients.
- •The design and implementation of the FI in the hospital setting will potentially provide both an outcome of interest as well as a possible variable capturing the complexity of the older patient.
Abstract
Background
Frailty is a state of increased vulnerability to stressors, associated to poor health
outcomes. The aim of this study was to design and introduce a Frailty Index (FI; according
to the age-related accumulation of deficit model) in a large cohort of hospitalized
older persons, in order to benefit from its capacity to comprehensively weight the
risk profile of the individual.
Methods
Patients aged 65 and older enrolled in the REPOSI register from 2010 to 2016 were
considered in the present analyses. Variables recorded at the hospital admission (including
socio-demographic, physical, cognitive, functional and clinical factors) were used
to compute the FI. The prognostic impact of the FI on in-hospital and 12-month mortality
was assessed.
Results
Among the 4488 patients of the REPOSI register, 3847 were considered eligible for
a 34-item FI computation. The median FI in the sample was 0.27 (interquartile range
0.21–0.37). The FI was significantly predictive of both in-hospital (OR 1.61, 95%CI
1.38–1.87) and overall (HR 1.46, 95%CI 1.32–1.62) mortality, also after adjustment
for age and sex.
Conclusions
The FI confirms its strong predictive value for negative outcomes. Its implementation
in cohort studies (including those conducted in the hospital setting) may provide
useful information for better weighting the complexity of the older person and accordingly
design personalized interventions.
Keywords
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Article info
Publication history
Published online: June 12, 2018
Accepted:
June 4,
2018
Received in revised form:
May 8,
2018
Received:
January 23,
2018
Identification
Copyright
© 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
