Frailty in older adults admitted to hospital: a six-year dual-centre retrospective study of over 53 000 clinical frailty scale assessments

Abstract

Aim To examine frailty assessments in older patients admitted to hospital, and explore associations with sex, admission and discharge status. Methodology Worldwide, the prevalence of frailty is increasing. Stratifying frailty can be beneficial at a population level to improve public health and target local services. At an individual level, recognition of frailty can help inform prognosis and advanced planning. The Clinical Frailty Scale (CFS) is validated for predicting outcomes of older hospitalised adults. All patients admitted into two hospitals in the South-East of England between 1 January 2017 and 31 December 2022, aged ≥65 years old with an electronically recorded CFS were included. Results Over the study period there were 100 933 admissions, representing 53 361 individual patients. A single admission was observed in 16 284 (30.5%), whilst 37 077 (69.5%) had more than one admission. The mean CFS was 4.62 (SD 1.66) and 49.5% were living with frailty (CFS ≥5). Across 6 years, before, during and after the Covid-19 pandemic, this percentage remained stable. Females had a higher average CFS than males (4.74 vs 4.46, P < 0.01). Patients with a single admission had a higher mean CFS than patients with subsequent readmissions. Patients who died during admission had a higher average CFS than those who survived to discharge (6.02 vs 4.52, P < 0.01). Conclusion This large cohort study of acutely admitted older adults found half were living with frailty. This highlights the importance of frailty identification to optimise personalised care. There was no significant change in frailty severity between 2018 and 2022.