Lopez Derrick, Murray Kevin, Preen David B, Sanfilippo Frank M, Trevenen Michelle, Hankey Graeme J, Yeap Bu B, Golledge Jonathan, Almeida Osvaldo P, Flicker Leon
School of Population and Global Health, The University of Western Australia, Crawley, Western Australia, Australia.
School of Population and Global Health, The University of Western Australia, Crawley, Western Australia, Australia.
J Am Med Dir Assoc. 2022 Aug;23(8):1348-1353.e8. doi: 10.1016/j.jamda.2021.09.033. Epub 2021 Nov 2.
The recently developed Hospital Frailty Risk Score (HFRS) allows ascertainment of frailty from administrative data. We aimed to compare the HFRS against the widely used FRAIL Scale and Frailty Index.
Population-based cohort study linked to Western Australian Hospital Morbidity Data Collection and Death Registrations.
The Health in Men Study with frailty determined at Wave 2 (2001/2004), mortality in the 1-year period following Wave 2, and disability at Wave 3 (2008). Participants were 4228 community-based men aged ≥75 years, followed until Wave 3.
We used multivariable regression to determine the association between each frailty measure and outcomes of length of stay (LOS), death, and disability. We also determined if the additional cases of frailty identified by one measure over the other was associated with these outcomes.
Of 4228 men studied, the HFRS (n = 689) identified fewer men as frail than the FRAIL Scale (n = 1648) and Frailty Index (n = 1820). In the fully adjusted models, all 3 frailty measures were associated with longer LOS and mortality, whereas only the FRAIL Scale and Frailty Index were significantly associated with disability. The additional cases of frailty identified by the FRAIL Scale and Frailty Index had longer LOS and greater risks of death and disability. The fully adjusted hazard ratio for death among the additional cases of frailty identified by the FRAIL Scale (compared to being not frail on both HFRS and FRAIL Scale) was 2.14 (95% CI 1.48-3.08).
The HFRS is associated with adverse outcomes. However, it identified approximately 60% fewer men who were frail than the FRAIL Scale and Frailty Index, and the additional cases identified were also at high risks of adverse outcomes. Users of the HFRS should be aware of the differences with other frailty measures.
最近开发的医院衰弱风险评分（HFRS）可通过行政数据确定衰弱情况。我们旨在将HFRS与广泛使用的衰弱量表（FRAIL量表）和衰弱指数进行比较。
基于人群的队列研究，与西澳大利亚医院发病率数据收集和死亡登记相关联。
男性健康研究，在第2波（2001/2004年）确定衰弱情况，在第2波后的1年期间确定死亡率，在第3波（2008年）确定残疾情况。参与者为4228名年龄≥75岁的社区男性，随访至第3波。
我们使用多变量回归来确定每种衰弱测量与住院时间（LOS）、死亡和残疾结局之间的关联。我们还确定了一种测量方法比另一种测量方法多识别出的衰弱额外病例是否与这些结局相关。
在研究的4228名男性中，HFRS（n = 689）识别出的衰弱男性比FRAIL量表（n = 1648）和衰弱指数（n = 1820）识别出的更少。在完全调整模型中，所有3种衰弱测量均与更长的住院时间和死亡率相关，而只有FRAIL量表和衰弱指数与残疾显著相关。FRAIL量表和衰弱指数识别出的衰弱额外病例住院时间更长，死亡和残疾风险更高。FRAIL量表识别出的衰弱额外病例（与HFRS和FRAIL量表均不衰弱相比）的完全调整后死亡风险比为2.14（95%CI 1.48 - 3.08）。
HFRS与不良结局相关。然而，它识别出的衰弱男性比FRAIL量表和衰弱指数少约60%，并且识别出的额外病例也有较高的不良结局风险。HFRS的使用者应注意与其他衰弱测量方法的差异。
