National Norms for Hospital Frailty Risk Score Among Hospitalized Adults in the USA.

Abstract

Background: Frailty among inpatients increases risk for hospital-associated disability and death. Yet, frailty is not regularly screened in acute care due to the lack of standardized methods, the complexity of frailty, and time and energy required of hospital personnel. Thus, screening with routinely collected data provides an opportunity to assess frailty across inpatient populations.

Objective: To calculate normative values for Hospital Frailty Risk Score (HFRS) among adult inpatients in the USA based on age, sex, and race.

Design: A retrospective cross-sectional analysis of the 2018 National Inpatient Sample (NIS) database.

Patients: US adult inpatients aged 18y + with a focus on patients aged at least 45.

Main measures: Hospital Frailty Risk Score (HFRS) is a validated measure that uses ICD-10 codes to calculate frailty risk among hospitalized patients.

Key results: Mean HFRS significantly increased with increasing age across sex and race (p < 0.001). Among the oldest age groups 65y + , mean and median normative values were similar between male and female inpatients (mean HFRS range, 6.71-9.62; median HFRS range, 5.40-8.70), and Black inpatients had the highest frailty risk compared to other races (mean HFRS range = 7.56-10.47; median HFRS range = 6.30-9.50). Asian/Pacific Islander inpatients had similar frailty risk to Black inpatients among those 90y + (mean HFRS = 10.48; median HFRS = 9.50).

Conclusions: The US national norms for HFRS provide a standardized reference tool for comparing frailty risk among clinical and research inpatient populations to a typical hospitalized adult for their age, sex, and race.