ArticleInternational journal of emergency medicine2025
Comparison of two electronic medical record-based frailty assessment tools and their association with adverse outcomes in older hospitalized patients with urgent admissions.
Article in International journal of emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundFrailty assessment is crucial for predicting outcomes in acute care settings; however, its application remains challenging. Therefore, this study aims to evaluate and compare two electronic medical record-based tools-the Canadian Institute for Health Information Hospital Frailty Risk Measure (CIHI-HFRM) and the United Kingdom Hospital Frailty Risk Score (UK-HFRS)-in older patients requiring urgent admission.
methodsIn this retrospective cohort study, we analyzed 35,564 patients aged 65 or older from the MIMIC-IV 2.0 database. Frailty was assessed using CIHI-HFRM and UK-HFRS. Primary outcomes included in-hospital mortality, one-year post-discharge mortality, post-discharge care needs, timely hospital discharge, and one-year readmission rates. Logistic regression, Cox regression, and competing risk models were used for analysis.
resultsThe CIHI-HFRM and UK-HFRS were significantly associated with in-hospital mortality [odds ratio (OR) per point: CIHI-HFRM 1.10 (95% confidence interval (CI) 1.07-1.13); UK-HFRS 1.06 (95% CI 1.05-1.07)] and one-year post-discharge mortality [hazard ratio (HR) per point: CIHI-HFRM 1.08 (95% CI 1.06-1.09); UK-HFRS 1.05 (95% CI 1.04-1.05)]. Both measures were associated with prolonged hospital stays and post-discharge care needs, while only CIHI-HFRM was linked to one-year readmission risk.
conclusionThe CIHI-HFRM and UK-HFRS effectively stratify adverse outcomes risk in older patients requiring urgent admission. They may be considered alongside traditional measures as part of a pragmatic multimodal pathway, which represents a potential direction for clinical application.
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