Impact of Frailty on Care Burden of Hospitalized Older Adults Receiving Colonoscopy: A 2016-2020 Nationwide Inpatient Sample Analysis.

BACKGROUND

Colonoscopy is a widely used diagnostic and therapeutic procedure. The impact of frailty on outcomes of hospitalized older patients undergoing colonoscopy is unclear. This study aims to evaluate associations between frailty and outcomes of hospitalized older adults undergoing colonoscopy.

METHODS

Data were extracted from the Nationwide Inpatient Sample (NIS), 2016-2020. Hospitalized patients ≥ 65 years old who underwent colonoscopy were included. Frailty was assessed using a modified frailty index (mFI), and frail was defined as mFI ≥ 0.27. The primary outcomes were in-hospital mortality, nonroutine discharge, prolonged length of stay (LOS) (≥ 75th percentile), postprocedural dysrhythmia, and other postprocedural complications.

RESULTS

A total of 142 257 hospitalized older adults were included, with 29 558 categorized as frail. The mean age was 77 years, and 54% were males. Frail patients had significantly higher in-hospital mortality (2.7% vs. 1.7%), nonroutine discharge (27.8% vs. 19.6%), prolonged LOS (33.9% vs. 24.2%), and postprocedural dysrhythmia (46.3% vs. 29.2%) compared to nonfrail patients (all, p < 0.001). After adjusting for covariates, frailty remained significantly associated with increased risks of in-hospital mortality (odds ratio [OR] = 1.60), nonroutine discharge (OR = 1.62), prolonged LOS (OR = 1.62), and postprocedural dysrhythmia (OR = 2.12). Stratified analyses by sex and age obtained the same results across all subgroups.

DISCUSSION

Frailty is significantly associated with adverse outcomes in hospitalized older adults undergoing colonoscopy. These findings highlight the importance of increased periprocedural care for frail patients to improve clinical outcomes and optimize resource utilization.