Aluko A Hope1, Oriade Adeoye2, Elizabeth H Chuang3, S J Hsieh2, Hayley B Gershengorn2, Michelle N Gong4. 1. Department of Medicine, Division of Critical Care Medicine, Montefiore Medical Center, Bronx, NY 10467, United States. Electronic address: ahope@montefiore.org. 2. Department of Medicine, Division of Critical Care Medicine, Montefiore Medical Center, Bronx, NY 10467, United States. 3. Department of Family and Social Medicine, Palliative Care Program at Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, United States. 4. Department of Medicine, Division of Critical Care Medicine, Montefiore Medical Center, Bronx, NY 10467, United States; Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States.
Abstract
PURPOSE: We aimed to estimate the independent effect of pre-hospital frailty (PHF) on hospital mortality and prolonged hospital length of stay (pLOS) while adjusting for other patient level factors. METHODS: This is a cohort study of hospitalized adults with acute respiratory failure (ARF) who required invasive mechanical ventilation for ≥24h in 2013. We used inpatient/outpatient claims from a list of diagnoses from the year before index hospital admission to define PHF. Differences in characteristics/outcomes by PHF were explored using descriptive statistics; multivariable logistic regression was used to estimate association between PHF and hospital outcomes. RESULTS: Among 1157 patients (mean age (standard deviation) 67.1 [16.4]), 53.2% had PHF. PHF was independently associated with higher hospital mortality (44.2% in PHF patients vs. 34.6% in those without, adjusted Odds Ratio (aOR) (95% Confidence Interval [CI] 1.56 (1.19-2.05), p<0.001). PHF was also significantly associated with pLOS in hospital survivors (55.5% PHF patients had pLOS versus 34.2% in those without, aOR (95% CI) 2.61 (1.87-3.65), p<0.001). CONCLUSIONS: PHF, identified by frailty diagnoses from before index hospitalization, may be a useful approach for identifying adults with ARF at increased risk of hospital mortality and pLOS.
PURPOSE: We aimed to estimate the independent effect of pre-hospital frailty (PHF) on hospital mortality and prolonged hospital length of stay (pLOS) while adjusting for other patient level factors. METHODS: This is a cohort study of hospitalized adults with acute respiratory failure (ARF) who required invasive mechanical ventilation for ≥24h in 2013. We used inpatient/outpatient claims from a list of diagnoses from the year before index hospital admission to define PHF. Differences in characteristics/outcomes by PHF were explored using descriptive statistics; multivariable logistic regression was used to estimate association between PHF and hospital outcomes. RESULTS: Among 1157 patients (mean age (standard deviation) 67.1 [16.4]), 53.2% had PHF. PHF was independently associated with higher hospital mortality (44.2% in PHFpatients vs. 34.6% in those without, adjusted Odds Ratio (aOR) (95% Confidence Interval [CI] 1.56 (1.19-2.05), p<0.001). PHF was also significantly associated with pLOS in hospital survivors (55.5% PHFpatients had pLOS versus 34.2% in those without, aOR (95% CI) 2.61 (1.87-3.65), p<0.001). CONCLUSIONS:PHF, identified by frailty diagnoses from before index hospitalization, may be a useful approach for identifying adults with ARF at increased risk of hospital mortality and pLOS.
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