A retrospective cohort study on the relationship between frailty and healthcare outcomes.

IF 3.3 Q2 GERIATRICS & GERONTOLOGY

Journal of Frailty & Aging Pub Date : 2025-05-23 DOI:10.1016/j.tjfa.2025.100053

Jinmyoung Cho, Joanne Salas, Jeffery F Scherrer, George Grossberg

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引用次数: 0

Abstract

Background: Frailty increases vulnerability for adverse outcomes in older adults. Characterizing the prevalence and distribution of frailty can help guide healthcare service decision-making and policy.

Objectives: This study evaluated the association between frailty and healthcare utilization and interactions by demographic characteristics.

Design: Using electronic health records (2018-2022), we conducted a retrospective cohort study with 355,266 patients ≥65 years of age who had ≥2 ambulatory office visits in separate years in the 4-year baseline period (2018-2021). The Gilbert Frailty Index (GFI) was calculated (low vs. intermediate vs. high) using ICD-10 codes. One-year utilization outcomes in 2022 included high outpatient clinic utilizations (OCU), inpatient (IP), emergency department (ED), and nursing home (NH) admissions. Fully adjusted log-binomial regression models were calculated overall and by race (White vs. Black), age groups, and gender.

Results: The sample was 74.5(±7.5) years of age, 57.7 % female, 89.2 % White, and 13.5 % categorized as GFI high. After adjustment for covariates, GFI high had the highest risk for all outcomes (RR=3.31 for IP; 2.77 for ED; 4.26 for NH; 1.60 for high OCU). We observed significant interactions by race, gender, and age for some outcomes. Effects of GFI high vs. low were larger for White (IP, ED, & high OCU), female patients (ED & high OCU), and younger patients (IP). Conversely, the effects of GFI high vs. low were strongest in older patients for ED, IP and high OCU.

Conclusions: Monitoring frailty and paying attention to patient's demographic characteristics is needed to best estimate associations between frailty and healthcare utilization.

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一项关于虚弱和保健结果之间关系的回顾性队列研究。

背景：老年人虚弱会增加不良结局的易感性。表征脆弱的患病率和分布可以帮助指导医疗服务决策和政策。目的：本研究通过人口统计学特征评估虚弱与医疗保健利用之间的关系和相互作用。设计：使用电子健康记录（2018-2022），我们对355,266名年龄≥65岁的患者进行了回顾性队列研究，这些患者在4年基线期（2018-2021）的不同年份有≥2次门诊就诊。使用ICD-10编码计算吉尔伯特脆弱指数（GFI）（低、中、高）。2022年一年的使用率结果包括高门诊使用率（OCU）、住院率（IP）、急诊科（ED）和养老院（NH）入院率。完全调整的对数-二项回归模型是按整体和种族（白人与黑人）、年龄组和性别计算的。结果：样本年龄为74.5（±7.5）岁，57.7%为女性，89.2%为白人，13.5%为GFI高。调整协变量后，GFI高的所有结局的风险最高(IP的RR=3.31；ED 2.77；NH为4.26；1.60为高OCU)。我们观察到种族、性别和年龄对某些结果有显著的相互作用。GFI高低对白人（IP、ED和高OCU）、女性患者（ED和高OCU）和年轻患者（IP）的影响更大。相反，GFI高低对老年ED、IP和高OCU患者的影响最大。结论：需要监测虚弱并关注患者的人口统计学特征，以最好地估计虚弱与医疗保健利用之间的关联。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Frailty & Aging GERIATRICS & GERONTOLOGY-

CiteScore

5.90

自引率

7.70%

发文量

期刊介绍： The Journal of Frailty & Aging is a peer-reviewed international journal aimed at presenting articles that are related to research in the area of aging and age-related (sub)clinical conditions. In particular, the journal publishes high-quality papers describing and discussing social, biological, and clinical features underlying the onset and development of frailty in older persons. The Journal of Frailty & Aging is composed by five different sections: - Biology of frailty and aging In this section, the journal presents reports from preclinical studies and experiences focused at identifying, describing, and understanding the subclinical pathophysiological mechanisms at the basis of frailty and aging. - Physical frailty and age-related body composition modifications Studies exploring the physical and functional components of frailty are contained in this section. Moreover, since body composition plays a major role in determining physical frailty and, at the same time, represents the most evident feature of the aging process, special attention is given to studies focused on sarcopenia and obesity at older age. - Neurosciences of frailty and aging The section presents results from studies exploring the cognitive and neurological aspects of frailty and age-related conditions. In particular, papers on neurodegenerative conditions of advanced age are welcomed. - Frailty and aging in clinical practice and public health This journal’s section is devoted at presenting studies on clinical issues of frailty and age-related conditions. This multidisciplinary section particularly welcomes reports from clinicians coming from different backgrounds and specialties dealing with the heterogeneous clinical manifestations of advanced age. Moreover, this part of the journal also contains reports on frailty- and age-related social and public health issues. - Clinical trials and therapeutics This final section contains all the manuscripts presenting data on (pharmacological and non-pharmacological) interventions aimed at preventing, delaying, or treating frailty and age-related conditions.The Journal of Frailty & Aging is a quarterly publication of original papers, review articles, case reports, controversies, letters to the Editor, and book reviews. Manuscripts will be evaluated by the editorial staff and, if suitable, by expert reviewers assigned by the editors. The journal particularly welcomes papers by researchers from different backgrounds and specialities who may want to share their views and experiences on the common themes of frailty and aging.The abstracting and indexing of the Journal of Frailty & Aging is covered by MEDLINE (approval by the National Library of Medicine in February 2016).