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Validation of the H...
Validation of the Hospital Frailty Risk Score in older surgical patients : A population-based retrospective cohort study
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- Gunnarsdottir, Gudrun M. (författare)
- Landspitali, Div Anaesthesia & Intens Care Med, Reykjavik, Iceland.;Univ Iceland, Fac Med, Reykjavik, Iceland.
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- Helgadottir, Solveig (författare)
- Uppsala universitet,Anestesiologi och intensivvård
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- Einarsson, Sveinn G. (författare)
- Landspitali, Div Anaesthesia & Intens Care Med, Reykjavik, Iceland.
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- Hreinsson, Kari (författare)
- Landspitali, Div Anaesthesia & Intens Care Med, Reykjavik, Iceland.
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- Whittle, John (författare)
- UCL, Div Surg & Intervent Sci, Ctr Perioperat Med, London, England.
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- Karason, Sigurbergur (författare)
- Landspitali, Div Anaesthesia & Intens Care Med, Reykjavik, Iceland.;Univ Iceland, Fac Med, Reykjavik, Iceland.
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- Sigurdsson, Martin I. (författare)
- Landspitali, Div Anaesthesia & Intens Care Med, Reykjavik, Iceland.;Univ Iceland, Fac Med, Reykjavik, Iceland.
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Landspitali, Div Anaesthesia & Intens Care Med, Reykjavik, Iceland;Univ Iceland, Fac Med, Reykjavik, Iceland. Anestesiologi och intensivvård (creator_code:org_t)
- 2021-05-18
- 2021
- Engelska.
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Ingår i: Acta Anaesthesiologica Scandinavica. - : John Wiley & Sons. - 0001-5172 .- 1399-6576. ; 65:8, s. 1033-1042
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Background: There is a need for standardized and cost-effective identification of frailty risk. The objective was to validate the Hospital Frailty Risk Score which utilizes International Classification Diagnoses in a cohort of older surgical patients, assess the score as an independent risk factor for adverse outcomes and compare discrimination properties of the frailty risk score with other risk stratification scores.Methods: Data were analysed from all patients >= 65 years undergoing primary surgical procedures from 2006-2018. Patients were categorized based on the frailty risk score. The primary outcomes were 30-day mortality and 180-day risk of readmission.Results: Of 16 793 patients evaluated, 7480 (45%), 7605 (45%) and 1708 (10%) had a low, intermediate and high risk of frailty. There was a higher incidence of 30-day mortality for individuals with intermediate (2.9%) and high (8.3%) compared with low (1.4%) risk of frailty (P < .001 for both comparisons). Similarly, the hazard of readmission within the first 180 days was higher for intermediate (HR 1.25; 95% CI: 1.16-1.34) and high (HR 1.84; 95% CI: 1.66-2.03) compared with low (HR 1.00, P < .001 for both comparisons) risk of frailty. The hazard of long-term mortality was higher for intermediate (HR 1.70; 95% CI: 1.61-1.80) and high (HR 4.16; 95% CI: 3.84-4.49) compared with low (HR 1.00, P < .001 for both comparisons) risk of frailty. Finally, long length of primary hospitalization occurred for 9.3%, 15.0% and 27.3% of individuals with low, intermediate and high frailty risk (P < .001 for all comparisons). A model including age and ASA classification had the best discrimination for 30-day mortality (AUC 0.862; 95% CI: 0.847-0.877).Conclusion: Our findings suggest that the Hospital Frailty Risk Score might be used to screen older surgical patients for risk of frailty. While only slightly improving prediction of 30-day mortality using the ASA classification, the Hospital Frailty Risk Score can be used to independently classify older patients for the risk of important outcomes using pre-existing readily available electronic data.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Geriatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Geriatrics (hsv//eng)
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