Jane Andreasen1, Mette Aadahl2, Erik Elgaard Sørensen3, Helle Højmark Eriksen4, Hans Lund5, Kim Overvad6. 1. Department of Physiotherapy and Occupational Therapy, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Sdr. Skovvej 15, 9000, Aalborg, Denmark. Electronic address: jaan@rn.dk. 2. Research Centre for Prevention and Health, The Capital Region of Denmark, Rigshospitalet- Glostrup Hospital, Ndr. Ringvej 57, Afsnit 84/85, 2600, Glostrup, Denmark; Department of Public Health, Faculty of Health Sciences, University of Copenhagen, Denmark. Electronic address: mette.aadahl@regionh.dk. 3. Department of Clinical Medicine, Aalborg University, Sdr. Skovvej 15, 9000, Aalborg, Denmark; Clinical Nursing Research Unit, Aalborg University Hospital, Sdr. Skovvej 15, 9000, Aalborg, Denmark. Electronic address: ees@rn.dk. 4. Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Sdr. Skovvej 15, 9000, Aalborg, Denmark. Electronic address: helle.e@rn.dk. 5. Centre for Evidence-Based Practice, Western Norway University of Applied Sciences, Inndalsveien 28, Postbox 7030, N-5020, Bergen, Norway. Electronic address: Hans.Lund@hvl.no. 6. Department of Cardiology, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark; Section for Epidemiology, Department of Public Health, Aarhus University, Bartholins Alle 2, 8000, Aarhus C, Denmark. Electronic address: ko@ph.au.dk.
Abstract
OBJECTIVE: To assess whether frailty in acutely admitted older medical patients, assessed by a self-report questionnaire and evaluation of functional level at discharge, was associated with readmission or death within 6 months after discharge. A second objective was to assess the predictive performance of models including frailty, functional level, and known risk factors. METHODS: A cohort study including acutely admitted older patients 65+ from seven medical and two acute medical units. The Tilburg Frailty Indicator (TFI), Timed-Up-and-Go (TUG), and grip strength (GS) exposure variables were measured. Associations were assessed using Cox regression with first unplanned readmission or death (all-causes) as the outcome. Prediction models including the three exposure variables and known risk factors were modelled using logistic regression and C-statistics. RESULTS: Of 1328 included patients, 50% were readmitted or died within 6 months. When adjusted for gender and age, there was an 88% higher risk of readmission or death if the TFI scores were 8-13 points compared to 0-1 points (HR 1.88, CI 1.38;2.58). Likewise, higher TUG and lower GS scores were associated with higher risk of readmission or death. The area under the curve for the prediction models ranged from 0.64 (0.60;0.68) to 0.72 (0.68;0.76). CONCLUSION: In acutely admitted older medical patients, higher frailty assessed by TFI, TUG, and GS was associated with a higher risk of readmission or death within 6 months after discharge. The performance of the prediction models was mediocre, and the models cannot stand alone as risk stratification tools in clinical practice.
OBJECTIVE: To assess whether frailty in acutely admitted older medical patients, assessed by a self-report questionnaire and evaluation of functional level at discharge, was associated with readmission or death within 6 months after discharge. A second objective was to assess the predictive performance of models including frailty, functional level, and known risk factors. METHODS: A cohort study including acutely admitted older patients 65+ from seven medical and two acute medical units. The Tilburg Frailty Indicator (TFI), Timed-Up-and-Go (TUG), and grip strength (GS) exposure variables were measured. Associations were assessed using Cox regression with first unplanned readmission or death (all-causes) as the outcome. Prediction models including the three exposure variables and known risk factors were modelled using logistic regression and C-statistics. RESULTS: Of 1328 included patients, 50% were readmitted or died within 6 months. When adjusted for gender and age, there was an 88% higher risk of readmission or death if the TFI scores were 8-13 points compared to 0-1 points (HR 1.88, CI 1.38;2.58). Likewise, higher TUG and lower GS scores were associated with higher risk of readmission or death. The area under the curve for the prediction models ranged from 0.64 (0.60;0.68) to 0.72 (0.68;0.76). CONCLUSION: In acutely admitted older medical patients, higher frailty assessed by TFI, TUG, and GS was associated with a higher risk of readmission or death within 6 months after discharge. The performance of the prediction models was mediocre, and the models cannot stand alone as risk stratification tools in clinical practice.
Authors: Tristan Struja; Daniel Koch; Sebastian Haubitz; Beat Mueller; Philipp Schuetz; Timo Siepmann Journal: Qual Life Res Date: 2021-05-18 Impact factor: 4.147
Authors: Cheng-Fu Lin; Yu-Hui Huang; Li-Ying Ju; Shuo-Chun Weng; Yu-Shan Lee; Yin-Yi Chou; Chu-Sheng Lin; Shih-Yi Lin Journal: Int J Environ Res Public Health Date: 2020-07-24 Impact factor: 3.390