The association between frailty and hospital-related adverse events in older hospitalised patients: a systematic literature review.

Abstract

Introduction: Studies have shown that hospital-related adverse events (AEs) affect older hospitalised patients. Frailty is an age-related syndrome of increased vulnerability, the risk of abrupt and extreme health changes, and the risk of suffering an adverse event (AE). Most of the published work focuses on the relationship between age alone and AEs' incidence. We aim to examine the association between frailty and the incidence of hospital-related AEs among hospitalised older adults in the published literature.

Methods: A comprehensive search of Ovid MEDLINE, CINAHL, Scopus, and Web of Science databases was conducted between January and February 2024. Studies were included if they provide original data in English, regardless of methodology. In addition, the reference lists of all included studies were manually screened to identify any further eligible studies. The narrative synthesis followed the Cochrane methodology.

Results: This review includes 19 observational studies, with the USA being the most common study location. Various frailty tools and definitions were used, with the frailty index (FI) being the most frequently employed tool. Hospital-acquired infections, including pneumonia, urinary tract infections (UTIs), sepsis and wound infections, were the most frequently reported adverse events, followed by delirium. In addition, falls, pressure ulcers and venous thromboembolism were also commonly documented.

Conclusion: This review found that frailty is associated with an increased risk of hospital-acquired infections, in-hospital delirium, falls and pressure ulcers. More extensive and comprehensive studies are needed to focus on patient safety incidents among frail hospitalised individuals.