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Frailty in an Adult Acute Hospital Population: Predictors, Prevalence, and Outcomes

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  • Rónán O’Caoimh

    (Department of Geriatric Medicine, Mercy University Hospital, Grenville Place, T12 WE28 Cork City, Ireland
    Health Research Board Clinical Research Facility, University College Cork, Mercy University Hospital, T12 WE28 Cork City, Ireland
    Department of Geriatric and Stroke Medicine, University Hospital Galway, Newcastle Rd, H91 YR71 Galway City, Ireland)

  • Laura Morrison

    (Department of Geriatric and Stroke Medicine, University Hospital Galway, Newcastle Rd, H91 YR71 Galway City, Ireland)

  • Maria Costello

    (Department of Geriatric and Stroke Medicine, University Hospital Galway, Newcastle Rd, H91 YR71 Galway City, Ireland)

  • Antoinette Flannery

    (Department of Geriatric and Stroke Medicine, University Hospital Galway, Newcastle Rd, H91 YR71 Galway City, Ireland)

  • Cliona Small

    (Department of Geriatric and Stroke Medicine, University Hospital Galway, Newcastle Rd, H91 YR71 Galway City, Ireland)

  • Liam O’Reilly

    (Department of Geriatric and Stroke Medicine, University Hospital Galway, Newcastle Rd, H91 YR71 Galway City, Ireland
    Department of Emergency Medicine, University Hospital Galway, Newcastle Rd, H91 YR71 Galway City, Ireland)

  • Laura Heffernan

    (Department of Geriatric and Stroke Medicine, University Hospital Galway, Newcastle Rd, H91 YR71 Galway City, Ireland
    Department of Emergency Medicine, University Hospital Galway, Newcastle Rd, H91 YR71 Galway City, Ireland)

  • Edel Mannion

    (Department of Geriatric and Stroke Medicine, University Hospital Galway, Newcastle Rd, H91 YR71 Galway City, Ireland)

  • Ruairi Waters

    (Department of Geriatric and Stroke Medicine, University Hospital Galway, Newcastle Rd, H91 YR71 Galway City, Ireland)

  • Shaun O’Keeffe

    (Department of Geriatric and Stroke Medicine, University Hospital Galway, Newcastle Rd, H91 YR71 Galway City, Ireland)

Abstract

Frailty is common among older hospital inpatients. While studies describe frailty prevalence in acute hospitals, it is usually based upon retrospective hospital-coded data or brief screening on admission rather than comprehensive geriatric assessment (CGA). Further, little is known about differences between pre-admission and current frailty status. Given this, we investigated the prevalence of pre-frailty and frailty among adult inpatients in a large university hospital after CGA. Of the 410 inpatients available, 398 were included in the study, with a median age of 70 years; 56% were male. The median length of stay (LOS) at review was 8 days. The point prevalence of frailty was 30% versus 14% for pre-frailty. The median Clinical Frailty Scale score pre-admission was 3/9, which was significantly lower than at review, which was 4/9 ( p < 0.001). After adjusting for age and sex, frailty was associated with greater odds of prolonged LOS (odds ratio [OR] 1.7, p = 0.045), one-year mortality (OR 2.1, p = 0.006), and one-year institutionalisation (OR 9, p < 0.001) but not re-admission. Frailty was most prevalent on medical and orthopaedic wards. In conclusion, CGA is an important risk assessment for hospitalised patients. Frailty was highly prevalent and associated with poor healthcare outcomes. Frailty status appears to worsen significantly during admission, likely reflecting acute illness, and it may not reflect a patient’s true frailty level. The development of frailty clinical care pathways is recommended in order to address the poor prognosis associated with a diagnosis of frailty in this setting.

Suggested Citation

  • Rónán O’Caoimh & Laura Morrison & Maria Costello & Antoinette Flannery & Cliona Small & Liam O’Reilly & Laura Heffernan & Edel Mannion & Ruairi Waters & Shaun O’Keeffe, 2024. "Frailty in an Adult Acute Hospital Population: Predictors, Prevalence, and Outcomes," IJERPH, MDPI, vol. 21(3), pages 1-13, February.
    • Handle: RePEc:gam:jijerp:v:21:y:2024:i:3:p:273-:d:1347090
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    References listed on IDEAS

    as
    1. Feifei Bu & Alasdair Rutherford, 2019. "Dementia, home care and institutionalisation from hospitals in older people," European Journal of Ageing, Springer, vol. 16(3), pages 283-291, September.
    2. Giuseppe Liotta & Silvia Ussai & Maddalena Illario & Rónán O’Caoimh & Antonio Cano & Carol Holland & Regina Roller-Winsberger & Alessandra Capanna & Chiara Grecuccio & Mariacarmela Ferraro & Francesca, 2018. "Frailty as the Future Core Business of Public Health: Report of the Activities of the A3 Action Group of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA)," IJERPH, MDPI, vol. 15(12), pages 1-26, December.
    3. Marie Condon & Edel Mannion & D. William Molloy & Rónán O’Caoimh, 2019. "Urinary and Faecal Incontinence: Point Prevalence and Predictors in a University Hospital," IJERPH, MDPI, vol. 16(2), pages 1-8, January.
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