Division of General Internal Medicine, University of Alberta, Edmonton, Alberta, Canada.
Alberta SPOR Support Unit Data Platform, University of Alberta, Edmonton, Alberta, Canada.
J Hosp Med. 2019 Jul 1;14(7):407-410. doi: 10.12788/jhm.3174. Epub 2019 Mar 20.
We compared prevalence estimates and prognostication if frailty were defined using the face-to-face Clinical Frailty Scale (CFS) or the administrative-data-derived Hospital Frailty Risk Score (HFRS). We evaluated 489 adults from a prospective cohort study of medical patients being discharged back to the community; 276 (56%) were deemed frail (214 [44%] on the HFRS and 161 [33%] on the CFS), but only 99 (20%) met both frailty definitions (kappa 0.24, 95% CI 0.16-0.33). Patients classified as frail on the CFS exhibited significantly higher 30-day readmission/death rates, 19% versus 10% for those not frail (aOR [adjusted odds ratio] 2.53, 95% CI 1.40-4.57) and 21% versus 6% for those aged >65 years (aOR 4.31, 95% CI 1.80-10.31). Patients with HFRS-defined frailty exhibited higher 30-day readmission/death rates that were not statistically significant (16% vs 11%, aOR 1.62 [95% CI 0.95-2.75] in all adults and 14% vs 11%, aOR 1.24 [95% CI 0.58-2.83] in those aged >65 years).
我们比较了使用面对面临床虚弱量表（CFS）或基于行政数据的医院虚弱风险评分（HFRS）定义虚弱时的患病率估计和预后。我们评估了来自医疗患者出院后返回社区的前瞻性队列研究中的 489 名成年人；276 人（56%）被认为虚弱（HFRS 为 214 人[44%]，CFS 为 161 人[33%]），但只有 99 人（20%）符合两种虚弱定义（kappa 0.24，95%CI 0.16-0.33）。在 CFS 上被归类为虚弱的患者 30 天内再入院/死亡率显著更高，分别为 19%和 10%（无虚弱者的调整后优势比[aOR]为 2.53，95%CI 1.40-4.57），年龄>65 岁者分别为 21%和 6%（aOR 为 4.31，95%CI 1.80-10.31）。HFRS 定义的虚弱患者的 30 天再入院/死亡率较高，但无统计学意义（16%对 11%，所有成年人的调整后优势比[aOR]为 1.62[95%CI 0.95-2.75]，年龄>65 岁者为 14%对 11%，aOR 为 1.24[95%CI 0.58-2.83]）。
