Frailty modifications and prognostic impact in older patients admitted in acute care

Background: Frailty is a predictor of adverse outcomes in older subjects. Aims: The aims of this study are to (1) measure the frailty status and its changes occurring during the hospital stay, (2) determine the relationships among frailty and adverse outcomes. Methods: Frailty was assessed using a 46-item Frailty Index (FI) in 156 patients admitted to an Acute Geriatric Medicine Unit. The FI was calculated within 24 h from the hospital admission (aFI) and at his/her discharge (dFI). Patients were followed up to 12 months after the hospital discharge. Results: A statistically significant difference was reported between the aFI (0.31, IQR 0.19–0.44) and the dFI (0.29, IQR 0.19–0.40; p = 0.04). The aFI was directly associated with the risk of in-hospital death (OR = 5.9; 95% CI 2.0–17.5; p = 0.001), 1 year mortality (OR = 5.5, 95% CI 2.4–12.7, p < 0.001) and re-hospitalization (OR = 6.3, 95% CI 2.2–17.9, p = 0.03). Conclusion: Frailty is a strong predictor of negative endpoints in hospitalized older persons. Discussion: Frailty assessment from routinely collected clinical data may provide important insights about the biological status of the individual and promote the personalization of care.