Transitions between degrees of multidimensional frailty among older people admitted to intermediate care: a multicentre prospective study
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2022Author:
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Amblàs-Novellas, J., Torné, A., Oller, R. et al. Transitions between degrees of multidimensional frailty among older people admitted to intermediate care: a multicentre prospective study, BMC Geriatrics, 2022, 22, 722Download Item:
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Abstract:
Background: Frailty is a dynamic condition that is clinically expected to change in older individuals during and
around admission to an intermediate care (IC) facility. We aimed to characterize transitions between degrees of frailty
before, during, and after admission to IC and assess the impact of these transitions on health outcomes.
Methods: Multicentre observational prospective study in IC facilities in Catalonia (North‑east Spain). The analysis
included all individuals aged ≥ 75 years (or younger with chronic complex or advanced diseases) admitted to an IC
facility. The primary outcome was frailty, measured by the Frail‑VIG index and categorized into four degrees: no frailty,
and mild, moderate, and advanced frailty. The Frail‑VIG index was measured at baseline (i.e., 30 days before IC admis‑
sion) (Frail‑VIG0), on IC admission (Frail‑VIG1), at discharge (Frail‑VIG2), and 30 days post‑discharge (Frail‑VIG3 ).
Results: The study included 483 patients with a mean (SD) age of 81.3 (10.2) years. At the time of admission, 27
(5.6%) had no frailty, and 116 (24%), 161 (33.3%), and 179 (37.1%) mild, moderate, and severe frailty, respectively. Most
frailty transitions occurred within the 30 days following admission to IC, particularly among patients with moder‑
ate frailty on admission. Most patients maintained their frailty status after discharge. Overall, 135 (28%) patients died
during IC stay. Frailty, measured either at baseline or admission, was significantly associated with mortality, although
it showed a stronger contribution when measured on admission (HR 1.16; 95%CI 1.10–1.22; p < 0.001) compared to
baseline (HR 1.10; 1.05–1.15; p < 0.001). When including frailty measurements at the two time points (i.e., baseline and
IC admission) in a multivariate model, frailty measured on IC admission but not at baseline significantly contributed to
explaining mortality during IC stay.
Conclusions: Frailty status varied before and during admission to IC. Of the serial frailty measures we collected, frailty
on IC admission was the strongest predictor of mortality. Results from this observational study suggest that routine
frailty measurement on IC admission could aid clinical management decisions.
Sponsor
Grant Number
Other
Instituto de Salud Carlos III 17/02240
Science Foundation Ireland (SFI)
18/FRL/6188
Author's Homepage:
http://people.tcd.ie/romeroorDescription:
PUBLISHED
Author: Romero-Ortuno, Roman
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BMC Geriatrics;Availability:
Full text availableKeywords:
Frailty, Frailty transitions, Intermediate care, Geriatrics, Older peopleSubject (TCD):
Ageing , Inclusive SocietyDOI:
https://doi.org/10.1186/s12877-022-03378-9Licences: