Development and validation of a frailty index derived from routinely
COLLECTED AND ELECTRONICALLY RECORDED HEALTH INFORMATION
Authors List Aickin, H., Waitematā District Health Board, Auckland, New Zealand (presenter) Bloomfield, K., Waitematā District Health Board & University of Auckland, Auckland, New Zealand Wu Z., University of Auckland, Auckland, New Zealand Connolly, MJ., Waitematā District Health Board & University of Auckland, Auckland, New Zealand
Introduction: Frailty is associated with adverse outcomes and increasing dependency. Rapid detection of frailty from routinely-collected electronic data is desirable. There are no studies utilising electronic data to assess frailty in New Zealand (NZ) inpatients.
Aim: Derive and validate a frailty index (FI) from routinely-collected electronic data in hospitalised older adults to predict adverse health outcomes.
Methods: A retrospective cohort of inpatients aged >65 years at Waitematā District Health Board (WDHB), NZ, with electronically recorded Global Geriatric Assessment (GGA) collected between May-2018 and October-2018. A FI was derived, applied to each participant then outcomes determined by level of frailty within 1 year of follow-up. The primary outcome was 6-month re-hospitalisation rate. Secondary outcomes were mortality and entrance into Residential Aged Care (RAC) at 1 year. T-tests determined difference of mean FIs among different outcomes. Chi-square tests assessed the relationship between outcomes and pre-specified Frailty Score (FS) groups (0-2, 3, 4, 5).
Results: The sample comprised 162 consecutive GGAs. Participants had a mean (SD) age of 86 (8.2) years, 108 (66.7%) were female and 143 (88%) identified as European/Pākehā. The mean (SD) FI was 0.42 (0.12). The 6-month hospitalisation rate for the lowest frailty group (FS 0-2) and highest frailty group (FS 5) was 35.7% and 66.7% respectively (p=0.04). The one-year mortality of FS 0-2 and FS 5 was 3.6% and 28.9% respectively (p=0.008). The one-year RAC admission of FS 0-2 and FS 5 was 14.3% and 54.1% respectively (p=0.001).
Conclusions: This study derived and operationalised a FI using routinely-collected electronic data from hospitalised older adults in WDHB. Higher FI scores were associated with higher risk of 6-month hospitalisation, one-year mortality, and one-year RAC admission. This is a novel application of the FI in NZ. This tool improves clinical identification of frailty and has significant potential for research purposes.
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