The overlap of frailty and malnutrition in older hospitalised patients: An observational study.

BACKGROUND AND OBJECTIVES

Frailty and malnutrition are geriatric syndromes with common risk-factors. Limited studies have investigated these two conditions simultaneously in hospitalised patients. This study investigated the overlap of frailty and malnutrition in older hospitalised patients.

METHODS AND STUDY DESIGN

This prospective study enrolled 263 patients ≥65 years in a tertiary-teaching hospital in Australia. Frailty status was assessed by use of the Edmonton-Frail-Scale (EFS) and malnutrition risk was determined by use of the Malnutrition Universal Screening Tool (MUST). Patients were divided into four categories for comparison: normal, at malnutrition- risk only, frail-only and both frail and at malnutrition risk. Multivariable regression models compared clinical outcomes: length of hospital stay (LOS), in-hospital mortality, health-related quality of life (HRQoL) and 30- day readmissions after adjustment for age, sex, Charlson comorbidity index (CCI) and living-status.

RESULTS

The mean (SD) age was 84.1 (6.6) years and 51.2% were females. The prevalence of patients who were at malnutrition- risk only was 14.8%, frailty only 27.8% and 33.5% were both frail and at malnutrition-risk. Frail-only patients were more likely to be older, from a nursing home and with a higher CCI than malnourished only patients. Frail patients had a worse HRQoL (coefficient -0.08, 95% -0.0132--0.031, p=0.002) and were more likely to have a longer LOS (coefficient 5.91, 95% CI 0.77-11.14, p=0.024) than patients at-risk of malnutrition. Other clinical outcomes were similar between the two groups.

CONCLUSIONS

There is a substantial overlap of frailty and malnutrition in older hospitalised patients and frailty is associated with worse clinical outcomes than malnutrition.