TY - JOUR
T1 - External Validation of the Hospital Frailty-Risk Score in Predicting Clinical Outcomes in Older Heart-Failure Patients in Australia
AU - Sharma, Yogesh
AU - Horwood, Chris
AU - Hakendorf, Paul
AU - Shahi, Rashmi
AU - Thompson, Campbell
PY - 2022/4/2
Y1 - 2022/4/2
N2 - Frailty is common in older hospitalised heart-failure (HF) patients but is not routinely assessed. The hospital frailty-risk score (HFRS) can be generated from administrative data, but it needs validation in Australian health-care settings. This study determined the HFRS scores at presentation to hospital in 5735 HF patients ≥ 75 years old, admitted over a period of 7 years, at two tertiary hospitals in Australia. Patients were classified into 3 frailty categories: HFRS < 5 (low risk), 5–15 (intermediate risk) and >15 (high risk). Multilevel multivariable regression analysis determined whether the HFRS predicts the following clinical outcomes: 30-day mortality, length of hospital stay (LOS) > 7 days, and 30-day readmissions; this was determined after adjustment for age, sex, Charlson index and socioeconomic status. The mean (SD) age was 76.1 (14.0) years, and 51.9% were female. When compared to the low-risk HFRS group, patients in the high-risk HFRS group had an increased risk of 30-day mortality and prolonged LOS (adjusted OR (aOR) 2.09; 95% CI 1.21–3.60) for 30-day mortality, and an aOR of 1.56 (95% CI 1.01–2.43) for prolonged LOS (c-statistics 0.730 and 0.682, respectively). Similarly, the 30-day readmission rate was significantly higher in the high-risk HFRS group when compared to the low-risk group (aOR 1.69; 95% CI 1.06–2.69; c-statistic = 0.643). The HFRS, derived at admission, can be used to predict ensuing clinical outcomes among older hospitalised HF patients.
AB - Frailty is common in older hospitalised heart-failure (HF) patients but is not routinely assessed. The hospital frailty-risk score (HFRS) can be generated from administrative data, but it needs validation in Australian health-care settings. This study determined the HFRS scores at presentation to hospital in 5735 HF patients ≥ 75 years old, admitted over a period of 7 years, at two tertiary hospitals in Australia. Patients were classified into 3 frailty categories: HFRS < 5 (low risk), 5–15 (intermediate risk) and >15 (high risk). Multilevel multivariable regression analysis determined whether the HFRS predicts the following clinical outcomes: 30-day mortality, length of hospital stay (LOS) > 7 days, and 30-day readmissions; this was determined after adjustment for age, sex, Charlson index and socioeconomic status. The mean (SD) age was 76.1 (14.0) years, and 51.9% were female. When compared to the low-risk HFRS group, patients in the high-risk HFRS group had an increased risk of 30-day mortality and prolonged LOS (adjusted OR (aOR) 2.09; 95% CI 1.21–3.60) for 30-day mortality, and an aOR of 1.56 (95% CI 1.01–2.43) for prolonged LOS (c-statistics 0.730 and 0.682, respectively). Similarly, the 30-day readmission rate was significantly higher in the high-risk HFRS group when compared to the low-risk group (aOR 1.69; 95% CI 1.06–2.69; c-statistic = 0.643). The HFRS, derived at admission, can be used to predict ensuing clinical outcomes among older hospitalised HF patients.
KW - frailty
KW - heart failure
KW - hospital frailty-risk score
KW - length of hospital stay
KW - mortality
KW - readmissions
UR - http://www.scopus.com/inward/record.url?scp=85128191285&partnerID=8YFLogxK
U2 - 10.3390/jcm11082193
DO - 10.3390/jcm11082193
M3 - Article
AN - SCOPUS:85128191285
SN - 2077-0383
VL - 11
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
IS - 8
M1 - 2193
ER -