Association of the Clinical Frailty Scale (CFS) with hospital outcomes
QJM: An International Journal of Medicine
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Wallis, S., Wall, J., Biram, R., & Romero-Ortuno, R. (2015). Association of the Clinical Frailty Scale (CFS) with hospital outcomes. QJM: An International Journal of Medicine, 108 943-949. https://doi.org/10.1093/qjmed/hcv066
Background: the clinical frailty scale (CFS) was validated as a predictor of adverse outcomes in community-dwelling older people. In our hospital, the use of the CFS in emergency admissions of people aged ≥ 75 years was introduced under the Commissioning for Quality and Innovation payment framework. Aim: we retrospectively studied the association of the CFS with patient characteristics and outcomes. Design: retrospective observational study in a large tertiary university National Health Service hospital in UK. Methods: the CFS was correlated with transfer to specialist Geriatric ward, length of stay (LOS), in-patient mortality and 30-day readmission rate. Results: between 1st August 2013 and 31st July 2014, there were 11 271 emergency admission episodes of people aged ≥ 75 years (all specialties), corresponding to 7532 unique patients (first admissions); of those, 5764 had the CFS measured by the admitting team (81% of them within 72 hr of admission). After adjustment for age, gender, Charlson comorbidity index and history of dementia and/or current cognitive concern, the CFS was an independent predictor of in-patient mortality [odds ratio (OR) = 1.60, 95% confidence interval (CI): 1.48 to 1.74, P < 0.001], transfer to Geriatric ward (OR = 1.33, 95% CI: 1.24 to 1.42, P < 0.001) and LOS ≥ 10 days (OR = 1.19, 95% CI: 1.14 to 1.23, P < 0.001). The CFS was not a multivariate predictor of 30-day readmission. Conclusions: the CFS may help predict in-patient mortality and target specialist geriatric resources within the hospital. Usual hospital metrics such as mortality and LOS should take into account measurable patient complexity.
Frail elderly, Geriatric assessment, Hospital medicine, Clinical frailty scale, Validation studies
External DOI: https://doi.org/10.1093/qjmed/hcv066
This record's URL: https://www.repository.cam.ac.uk/handle/1810/247791