Preadmission frailty status as a powerful predictor of dependency after discharge among hospitalized older patients: A clinical-based prospective study.

AIM

Frailty is a predictor of several adverse health outcomes in older adults. However, the relationship between preadmission frailty status and the incidence of dependency after discharge in hospitalized older patients remains unclear. The aim of the present study was to determine whether preadmission frailty status can predict dependency after discharge among hospitalized older patients.

METHODS

We analyzed the cohort data for hospitalized older patients (aged ≥65 years) with internal medical problems obtained from a prospective study. The main outcome was the incidence of dependency from admission to a month after discharge. The frailty status was assessed using the Kihon Checklist. We defined scores of ≥8 as frail, 4-7 as pre-frail and 0-3 as robust. The Cox proportional hazards regression model was used to estimate the hazard ratios and confidence intervals of the relationships between preadmission frailty status and the incidence of dependency.

RESULTS

A total of 151 participants who completed follow ups were analyzed (mean age 77.2 years [SD 6.9 years]). The prevalence of frailty, pre-frailty and robust was 22.5%, 37.8% and 39.7%, respectively. During the follow-up period, 39 participants (25.8%) had an incidence of dependency. Participants with frailty (adjusted hazard ratio 4.29, 95% confidence interval 1.72-10.69) had a significantly elevated incidence of dependency compared with that of robust participants. Participants with pre-frailty (adjusted hazard ratio 1.27, 95% confidence interval 0.51-10.69) had no significantly elevated incidence of dependency compared with robust participants.

CONCLUSIONS

The preadmission frailty status using the Kihon Checklist can predict the incidence of dependency after discharge among hospitalized older patients. Geriatr Gerontol Int 2018; 18: 1609-1613.