The Hospital Frailty Risk Score Identifies Fewer Cases of Frailty in a Community-Based Cohort of Older Men Than the FRAIL Scale and Frailty Index

Derrick Lopez; Kevin Murray; David B. Preen; Frank M. Sanfilippo; Michelle Trevenen; Graeme J. Hankey; Bu B. Yeap; Jonathan Golledge; Osvaldo P. Almeida; Leon Flicker

doi:10.1016/j.jamda.2021.09.033

The Hospital Frailty Risk Score Identifies Fewer Cases of Frailty in a Community-Based Cohort of Older Men Than the FRAIL Scale and Frailty Index

Derrick Lopez, Kevin Murray, David B. Preen, Frank M. Sanfilippo, Michelle Trevenen, Graeme J. Hankey, Bu B. Yeap, Jonathan Golledge, Osvaldo P. Almeida, Leon Flicker

Research output: Contribution to journal › Article › peer-review

3 Citations (Web of Science)

Abstract

Objectives
The recently developed Hospital Frailty Risk Score (HFRS) allows ascertainment of frailty from administrative data. We aimed to compare the HFRS against the widely used FRAIL Scale and Frailty Index.

Design
Population-based cohort study linked to Western Australian Hospital Morbidity Data Collection and Death Registrations.

Setting and Participants
The Health in Men Study with frailty determined at wave 2 (2001/2004), mortality in the 1-year period following wave 2, and disability at wave 3 (2008). Participants were 4228 community-based men aged ≥75 years, followed until wave 3.

Measurements
We used multivariable regression to determine the association between each frailty measure and outcomes of length of stay (LOS), death, and disability. We also determined if the additional cases of frailty identified by one measure over the other was associated with these outcomes.

Results
Of 4228 men studied, the HFRS (n = 689) identified fewer men as frail than the FRAIL Scale (n = 1648) and Frailty Index (n = 1820). In the fully adjusted models, all 3 frailty measures were associated with longer LOS and mortality, whereas only the FRAIL Scale and Frailty Index were significantly associated with disability. The additional cases of frailty identified by the FRAIL Scale and Frailty Index had longer LOS and greater risks of death and disability. The fully adjusted hazard ratio for death among the additional cases of frailty identified by the FRAIL Scale (compared to being not frail on both HFRS and FRAIL Scale) was 2.14 (95% CI 1.48-3.08).

Conclusions and Implications
The HFRS is associated with adverse outcomes. However, it identified approximately 60% fewer men who were frail than the FRAIL Scale and Frailty Index, and the additional cases identified were also at high risks of adverse outcomes. Users of the HFRS should be aware of the differences with other frailty measures.

Original language	English
Pages (from-to)	1348-1353.e8
Journal	Journal of the American Medical Directors Association
Volume	23
Issue number	8
DOIs	https://doi.org/10.1016/j.jamda.2021.09.033
Publication status	Published - Aug 2022

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10.1016/j.jamda.2021.09.033

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Lopez, D., Murray, K., Preen, D. B., Sanfilippo, F. M., Trevenen, M., Hankey, G. J., Yeap, B. B., Golledge, J., Almeida, O. P., & Flicker, L. (2022). The Hospital Frailty Risk Score Identifies Fewer Cases of Frailty in a Community-Based Cohort of Older Men Than the FRAIL Scale and Frailty Index. Journal of the American Medical Directors Association, 23(8), 1348-1353.e8. https://doi.org/10.1016/j.jamda.2021.09.033

@article{a42612db0af24ac685dbc34e76f1dadd,

title = "The Hospital Frailty Risk Score Identifies Fewer Cases of Frailty in a Community-Based Cohort of Older Men Than the FRAIL Scale and Frailty Index",

abstract = "ObjectivesThe recently developed Hospital Frailty Risk Score (HFRS) allows ascertainment of frailty from administrative data. We aimed to compare the HFRS against the widely used FRAIL Scale and Frailty Index.DesignPopulation-based cohort study linked to Western Australian Hospital Morbidity Data Collection and Death Registrations.Setting and ParticipantsThe Health in Men Study with frailty determined at wave 2 (2001/2004), mortality in the 1-year period following wave 2, and disability at wave 3 (2008). Participants were 4228 community-based men aged ≥75 years, followed until wave 3.MeasurementsWe used multivariable regression to determine the association between each frailty measure and outcomes of length of stay (LOS), death, and disability. We also determined if the additional cases of frailty identified by one measure over the other was associated with these outcomes.ResultsOf 4228 men studied, the HFRS (n = 689) identified fewer men as frail than the FRAIL Scale (n = 1648) and Frailty Index (n = 1820). In the fully adjusted models, all 3 frailty measures were associated with longer LOS and mortality, whereas only the FRAIL Scale and Frailty Index were significantly associated with disability. The additional cases of frailty identified by the FRAIL Scale and Frailty Index had longer LOS and greater risks of death and disability. The fully adjusted hazard ratio for death among the additional cases of frailty identified by the FRAIL Scale (compared to being not frail on both HFRS and FRAIL Scale) was 2.14 (95% CI 1.48-3.08).Conclusions and ImplicationsThe HFRS is associated with adverse outcomes. However, it identified approximately 60% fewer men who were frail than the FRAIL Scale and Frailty Index, and the additional cases identified were also at high risks of adverse outcomes. Users of the HFRS should be aware of the differences with other frailty measures.",

keywords = "Geriatric assessment, Frailty, Longitudinal cohort study, Epidemiology, Administrative data",

author = "Derrick Lopez and Kevin Murray and Preen, {David B.} and Sanfilippo, {Frank M.} and Michelle Trevenen and Hankey, {Graeme J.} and Yeap, {Bu B.} and Jonathan Golledge and Almeida, {Osvaldo P.} and Leon Flicker",

year = "2022",

month = aug,

doi = "10.1016/j.jamda.2021.09.033",

language = "English",

volume = "23",

pages = "1348--1353.e8",

journal = "Journal of the American Medical Directors Association",

issn = "1525-8610",

publisher = "Academic Press",

number = "8",

}

Lopez, D , Murray, K , Preen, DB , Sanfilippo, FM , Trevenen, M , Hankey, GJ , Yeap, BB, Golledge, J, Almeida, OP & Flicker, L 2022, 'The Hospital Frailty Risk Score Identifies Fewer Cases of Frailty in a Community-Based Cohort of Older Men Than the FRAIL Scale and Frailty Index', Journal of the American Medical Directors Association, vol. 23, no. 8, pp. 1348-1353.e8. https://doi.org/10.1016/j.jamda.2021.09.033

The Hospital Frailty Risk Score Identifies Fewer Cases of Frailty in a Community-Based Cohort of Older Men Than the FRAIL Scale and Frailty Index. / Lopez, Derrick ; Murray, Kevin ; Preen, David B. et al.

In: Journal of the American Medical Directors Association, Vol. 23, No. 8, 08.2022, p. 1348-1353.e8.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - The Hospital Frailty Risk Score Identifies Fewer Cases of Frailty in a Community-Based Cohort of Older Men Than the FRAIL Scale and Frailty Index

AU - Lopez, Derrick

AU - Murray, Kevin

AU - Preen, David B.

AU - Sanfilippo, Frank M.

AU - Trevenen, Michelle

AU - Hankey, Graeme J.

AU - Yeap, Bu B.

AU - Golledge, Jonathan

AU - Almeida, Osvaldo P.

AU - Flicker, Leon

PY - 2022/8

Y1 - 2022/8

N2 - ObjectivesThe recently developed Hospital Frailty Risk Score (HFRS) allows ascertainment of frailty from administrative data. We aimed to compare the HFRS against the widely used FRAIL Scale and Frailty Index.DesignPopulation-based cohort study linked to Western Australian Hospital Morbidity Data Collection and Death Registrations.Setting and ParticipantsThe Health in Men Study with frailty determined at wave 2 (2001/2004), mortality in the 1-year period following wave 2, and disability at wave 3 (2008). Participants were 4228 community-based men aged ≥75 years, followed until wave 3.MeasurementsWe used multivariable regression to determine the association between each frailty measure and outcomes of length of stay (LOS), death, and disability. We also determined if the additional cases of frailty identified by one measure over the other was associated with these outcomes.ResultsOf 4228 men studied, the HFRS (n = 689) identified fewer men as frail than the FRAIL Scale (n = 1648) and Frailty Index (n = 1820). In the fully adjusted models, all 3 frailty measures were associated with longer LOS and mortality, whereas only the FRAIL Scale and Frailty Index were significantly associated with disability. The additional cases of frailty identified by the FRAIL Scale and Frailty Index had longer LOS and greater risks of death and disability. The fully adjusted hazard ratio for death among the additional cases of frailty identified by the FRAIL Scale (compared to being not frail on both HFRS and FRAIL Scale) was 2.14 (95% CI 1.48-3.08).Conclusions and ImplicationsThe HFRS is associated with adverse outcomes. However, it identified approximately 60% fewer men who were frail than the FRAIL Scale and Frailty Index, and the additional cases identified were also at high risks of adverse outcomes. Users of the HFRS should be aware of the differences with other frailty measures.

AB - ObjectivesThe recently developed Hospital Frailty Risk Score (HFRS) allows ascertainment of frailty from administrative data. We aimed to compare the HFRS against the widely used FRAIL Scale and Frailty Index.DesignPopulation-based cohort study linked to Western Australian Hospital Morbidity Data Collection and Death Registrations.Setting and ParticipantsThe Health in Men Study with frailty determined at wave 2 (2001/2004), mortality in the 1-year period following wave 2, and disability at wave 3 (2008). Participants were 4228 community-based men aged ≥75 years, followed until wave 3.MeasurementsWe used multivariable regression to determine the association between each frailty measure and outcomes of length of stay (LOS), death, and disability. We also determined if the additional cases of frailty identified by one measure over the other was associated with these outcomes.ResultsOf 4228 men studied, the HFRS (n = 689) identified fewer men as frail than the FRAIL Scale (n = 1648) and Frailty Index (n = 1820). In the fully adjusted models, all 3 frailty measures were associated with longer LOS and mortality, whereas only the FRAIL Scale and Frailty Index were significantly associated with disability. The additional cases of frailty identified by the FRAIL Scale and Frailty Index had longer LOS and greater risks of death and disability. The fully adjusted hazard ratio for death among the additional cases of frailty identified by the FRAIL Scale (compared to being not frail on both HFRS and FRAIL Scale) was 2.14 (95% CI 1.48-3.08).Conclusions and ImplicationsThe HFRS is associated with adverse outcomes. However, it identified approximately 60% fewer men who were frail than the FRAIL Scale and Frailty Index, and the additional cases identified were also at high risks of adverse outcomes. Users of the HFRS should be aware of the differences with other frailty measures.

KW - Geriatric assessment

KW - Frailty

KW - Longitudinal cohort study

KW - Epidemiology

KW - Administrative data

UR - https://www.jamda.com/article/S1525-8610(21)00869-0/fulltext

U2 - 10.1016/j.jamda.2021.09.033

DO - 10.1016/j.jamda.2021.09.033

M3 - Article

C2 - 34740563

VL - 23

SP - 1348-1353.e8

JO - Journal of the American Medical Directors Association

JF - Journal of the American Medical Directors Association

SN - 1525-8610

IS - 8

ER -

The Hospital Frailty Risk Score Identifies Fewer Cases of Frailty in a Community-Based Cohort of Older Men Than the FRAIL Scale and Frailty Index

Abstract

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Trajectories of circulating testosterone and estradiol and implications for the health of ageing men

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The Hospital Frailty Risk Score Identifies Fewer Cases of Frailty in a Community-Based Cohort of Older Men Than the FRAIL Scale and Frailty Index

Abstract

Access to Document

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Projects

Trajectories of circulating testosterone and estradiol and implications for the health of ageing men

Successful Ageing in Older Men - Thriving Not Just Surviving in the Health In Men Study

Predicting Health & Disease in Australian Men Over the Age of 80 Years - the Health in Men Study

Cite this