January 08, 2020
A measurement of frailty created from the results of common lab tests could help to predict the risk of poorer outcomes among hospitalized older adults, according to the results of a new study.
In order to understand how frailty among acutely ill older adults affects post-hospitalization outcomes, the researchers conducted a prospective cohort study of 1750 older adults (mean age 84.6 years) admitted to a large hospital in the United Kingdom. The researchers created a frailty index using routine admission laboratory investigations (FI-Laboratory) linked to hospital outcomes data.
Overall, there were 2552 hospital admissions among the 1750 adults. FI-Laboratory values were generated for 2254 admissions. When testing correlation with the Clinical Frailty Scale (CFS), they found that an increase in the CFS and the equivalent increase in FI-Laboratory were associated with an increased proportion of inpatient days, discharge to a higher level of care, increased readmission rate, and mortality.
“Assessing clinical frailty in the acute care setting is difficult. The FI-Laboratory can help to identify complex, acutely ill older adults at hospital admission who have accumulated multiple health deficits and are at an increased risk of adverse outcomes. However, whether its use results in improved clinical outcomes is not known. It also remains to be determined whether changes in the FI-Laboratory during hospital admission might add prognostic information during the course of a hospital stay, whether in relation to recovery or to a higher burden of frailty. These possibilities are motivating additional research by our group,” they concluded.
Ellis HL, Wan B, Yeung M, et al. Complementing chronic frailty assessment at hospital admission with an electronic frailty index (FI-Laboratory) comprising routine blood test results [published online January 6, 2020]. CMAJ. https://doi.org/10.1503/cmaj.190952.