European Geriatric Medicine最新文献

{"title":"Chronic kidney disease and mortality in fragility fracture patients: revisiting GFR thresholds.","authors":"Joany Mariño, Paula Strittmatter, Maik Gollasch, Matthias Frank, Maximilian König","doi":"10.1007/s41999-025-01286-w","DOIUrl":"https://doi.org/10.1007/s41999-025-01286-w","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic kidney disease (CKD) is common in older adults. Still, its significance in patients with fragility fractures remains unclear, as does the clinical relevance of only mild-to-moderate CKD (GFR of 45-59 ml/min/1.73 m²) in older adults in general. We investigated how different eGFR categories (< 45, 45-59, and ≥ 60 ml/min/1.73 m²) are associated with mortality and functional outcomes in orthogeriatric patients.</p><p><strong>Methods: </strong>This retrospective cohort study included 453 consecutive patients admitted to an orthogeriatric unit from 2015 to 2023. Estimated glomerular filtration rate (eGFR) at admission was categorized into < 45, 45-59, and ≥ 60 ml/min/1.73 m². Outcomes included mortality (via Kaplan-Meier curves, regression, and ROC analysis), in-hospital complications, and functional recovery. Mediation by frailty was also analyzed.</p><p><strong>Results: </strong>Patients had a mean age of 82.9 ± 6.8 years; 74.8% were female. CKD was prevalent: 52.4% had eGFR < 60, and 33.6% had eGFR < 45 ml/min/1.73 m². Those with eGFR < 45 ml/min/1.73 m² had worse baseline functional status, more comorbidities, and poorer recovery. The 45-59 group showed similar or better outcomes than those with eGFR ≥ 60 ml/min/1.73 m², including mortality. Long-term all-cause mortality was significantly higher in the < 45 ml/min/1.73 m² group (HR 1.77, 95% CI 1.25-2.51), but not in the 45-59 ml/min/1.73 m² group (HR 1.01, 95% CI 0.64-1.58).</p><p><strong>Conclusion: </strong>In orthogeriatric patients, an eGFR < 45 ml/min/1.73 m² identifies individuals at higher risk of poor outcomes. However, eGFR 45-59 is not associated with adverse prognosis and may not warrant classification as CKD in this context. A lower diagnostic threshold may better reflect clinical realities in this population.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards a core outcome set for sarcopenia intervention studies: a scoping review identifying the most frequently reported outcomes across randomized controlled trials in sarcopenia.","authors":"S Van Heden, Y M Chan, Z Baoubbou, O Bruyère, J-Y Reginster, M Surquin, D Sanchez-Rodriguez, C Beaudart","doi":"10.1007/s41999-025-01285-x","DOIUrl":"https://doi.org/10.1007/s41999-025-01285-x","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to identify the most frequently reported outcomes in sarcopenia trials, as a basis for developing a Core Outcome Set (COS).</p><p><strong>Material and methods: </strong>A systematic review was conducted with a comprehensive search of MEDLINE, Embase, and Cochrane Central Register of Controlled Trials from database inception to March 2024 (PRISMA guidelines, PROSPERO: CRD42024525506). Eligible studies were randomized controlled trials (RCTs) on sarcopenia treatment, including patients diagnosed with a consensus definition. All outcomes reported in those studies were extracted and grouped into predefined subcategories.</p><p><strong>Results: </strong>Among 3985 references, 58 studies (54 unique RCTs) met the inclusion criteria, reporting 214 efficacy and 39 safety outcomes. The most frequently reported outcomes were muscle mass (50 studies, i.e., present in 86.2% of studies), muscle strength (50 studies, 86.2%), physical performance (46 studies, 79.3%), nutrition-related outcomes (29 studies, 50.0%), and fat mass (28 studies, 48.3%). Among the primary outcomes, change in muscle mass was the most commonly reported outcome (23 studies, 39.7%, with appendicular skeletal muscle mass index and fat-free mass as the predominant measures), followed by change in muscle strength (16 studies, 27.6%, mainly assessed by handgrip strength), followed by change in physical performance (13 studies, 22.4%, mainly assessed by gait speed and lower limb physical function). Secondary outcomes included biomarkers, physical status, quality of life, activities of daily living, bone mass, psychological status, cognitive function, and unclassified outcomes.</p><p><strong>Conclusions: </strong>This review highlights the extensive heterogeneity of reported outcomes in sarcopenia intervention studies and the urgent need for developing a COS.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive tele-home follow-ups versus comprehensive usual home follow-ups to reduce fear of falling after hospital discharge in older adults with fragile hip fractures: a non-inferiority study.","authors":"Suphawita Pliannuom, Phichayut Phinyo, Nida Buawangpong, Nopakoon Nantsupawat, Pichitchai Atthakomol, Tanawat Vaseenon, Nitchanant Kitcharanant, Thanachat Yotruangsri, Peerasak Lerttrakarnnon, Kanokporn Pinyopornpanish","doi":"10.1007/s41999-025-01284-y","DOIUrl":"https://doi.org/10.1007/s41999-025-01284-y","url":null,"abstract":"<p><strong>Purpose: </strong>Fear of falling (FoF) is common in older adults with fragility hip fractures after hospital discharge, leading to negative health outcomes. Evidence on tele-home visits' effectiveness in managing FoF remains limited. This study compares FoF outcomes between tele-home visits and usual home visits 2 months post-discharge.</p><p><strong>Methods: </strong>A prospective observational cohort study was conducted at a tertiary care hospital in Thailand, involving older adults aged 60 years and above who experienced fragility hip fractures and were hospitalized between March 2023 and May 2024. Participants were assigned to either tele-home or usual home visits based on their travel time from the hospital. The primary outcome was the change in FoF from 2 weeks to 2 months after discharge, measured using the Short Falls Efficacy Scale-International (Short FES-I). The study tested whether tele-home visits were non-inferior to usual home visits, using inverse probability of treatment weighting (IPTW) to adjust for baseline differences and a non-inferiority margin of 3.51.</p><p><strong>Results: </strong>The study included 106 patients (mean age 78.96 ± 9.24 years; 77.36% female). After IPTW, both groups showed improvement in FoF, with a mean reduction of -5.06 (95% confidence interval; 95% CI -5.90 to -4.22) in the tele-home visits group and -4.02 (95% CI -5.24 to -2.80) in the usual home visits group. The difference was -1.04 (95% CI -2.52 to 0.45), supporting the non-inferiority of tele-home visits.</p><p><strong>Conclusions: </strong>Tele-home visits are non-inferior to usual home visits in reducing FoF and can be provided for older adults with fragility hip fractures after hospital discharge. These findings offer greater convenience for continued care and improved access to care, even in remote areas.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geriatricians and occupational therapists' perspectives on the role of occupational therapy in delirium care in long-term care settings: a multi-site study.","authors":"Christian Pozzi, Giulia Borgonovo, Juan Antonio Lopez Segura, ABirgitta Gunnarsson, Laura N Gitlin","doi":"10.1007/s41999-025-01282-0","DOIUrl":"https://doi.org/10.1007/s41999-025-01282-0","url":null,"abstract":"<p><strong>Background: </strong>Delirium is a frequent and serious condition in older adults in long-term care (LTC), often underdiagnosed and insufficiently addressed despite its significant impact on morbidity and mortality. Occupational therapists (OTs) may play a key role in non-pharmacological prevention and treatment approaches, yet their specific contribution may remain unclear and undervalued in clinical practice.</p><p><strong>Objective: </strong>This study explored the perceptions of geriatricians and OTs regarding the role of OT in delirium care in LTC settings across three European countries.</p><p><strong>Methods: </strong>A qualitative, multi-site study was conducted through semi-structured interviews with six geriatrician-occupational therapist dyads working in LTC settings in Italy, Spain, and Switzerland. Transcripts were analyzed thematically through inductive coding.</p><p><strong>Results: </strong>Three main conceptual categories emerged: (1) the perceptions of the OT's role by geriatricians, (2) the goals and interventions of OTs in delirium care, and (3) barriers and facilitators to OT involvement. Geriatricians with greater familiarity with OTs recognized their role in prevention through environmental modifications and meaningful activity promotion, whereas others saw OTs' contributions as overlapping with physiotherapy. OTs often lacked standardized tools and specific training for delirium care, and caregiver involvement was minimal. Barriers included time constraints, unclear interprofessional roles, and limited geriatric training; facilitators included strong interdisciplinary collaboration and supportive teams.</p><p><strong>Conclusion: </strong>Enhancing the role of occupational therapy in delirium care requires clearer interprofessional definitions, dedicated training, and structural support in LTC. Structured collaboration between geriatricians and OTs may improve prevention and management outcomes for delirium in older adults.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What is HOME? Exploring learning themes in a home-visit educational program for postgraduate residents in Taiwan.","authors":"Yu-Tai Lo, Shih-Ming Li, Chia-Jung Hu, Shih-Han Hsiao, Yi-Ching Yang, Deng-Chi Yang","doi":"10.1007/s41999-025-01283-z","DOIUrl":"https://doi.org/10.1007/s41999-025-01283-z","url":null,"abstract":"<p><strong>Purpose: </strong>Physician home visits are essential for delivering care to frail, homebound older adults with limited access to routine healthcare. This study examined the experiential learning themes of a home-visit course within a postgraduate year training program in Taiwan.</p><p><strong>Methods: </strong>A descriptive, exploratory qualitative study was conducted to examine the learning experiences of second-year postgraduate residents who participated in 10 half-days home-visit program as part of their mandatory geriatric medicine training at a university hospital between August 1, 2020, and July 31, 2021. Reflective essays from 47 residents were analyzed using qualitative content analysis to identify key themes.</p><p><strong>Results: </strong>Three major themes emerged: learning process, learning content, and challenges. The learning process comprised four stages: adaptation, observation, awareness, and reflection. Learning content included a deeper understanding of patients as individuals within the community (holistic care), improved skills in coordinating interdisciplinary teams and integrating patient care information (organizational thinking), greater awareness and empathy through relational practices (mindful engagement), and a stronger appreciation for empowering patients and families through education, goal setting, and community support (empowerment)-conceptualized as the HOME model. Residents also identified challenges in negotiating family dynamics, navigating structural constraints, and reconciling gaps between policy ideals and the realities of home-based care.</p><p><strong>Conclusion: </strong>These findings support the integration of structured home-visit experiences into postgraduate training to promote competency development, person-centered care, and reflective learning in real-world settings.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of prescribing and health-related quality of life in older adults: a narrative review with a special focus on patients with atrial fibrillation and multimorbidity.","authors":"Cheima Amrouch, Deirdre A Lane, Amaia Calderón-Larrañaga, Mirko Petrovic, Delphine De Smedt","doi":"10.1007/s41999-025-01175-2","DOIUrl":"10.1007/s41999-025-01175-2","url":null,"abstract":"<p><strong>Purpose: </strong>To summarise the association between potentially inappropriate prescribing (PIP) and health-related quality of life (HRQOL) in older adults, with a special focus on those with atrial fibrillation (AF) and multimorbidity, while exploring potential interventions to improve prescribing quality and their impact on HRQOL.</p><p><strong>Methods: </strong>A comprehensive search strategy was conducted in MEDLINE using the PubMed interface on August 16th, 2024, focusing on key terms related to \"potentially inappropriate prescribing\" and \"quality of life\". Additionally, the reference lists of included studies were screened. Only studies utilising validated assessment tools for HRQOL or measuring global self-perceived health status were considered. Studies involving populations with an average age of  ≥ 65 years were included.</p><p><strong>Results: </strong>Of the 1810 articles screened, 35 studies were included. The findings indicate that the quality of prescribing, independent of polypharmacy, may negatively influence HRQOL. The review identified a range of interventions aimed at improving prescribing quality among older adults, including pharmacist-driven, general practitioner-driven, and multidisciplinary approaches. Interventions were assessed among distinct population groups and specifically in residential care homes. While some interventions demonstrated improvements in prescribing quality, the overall evidence regarding their impact on HRQOL remains limited.</p><p><strong>Conclusion: </strong>The relationship between prescribing quality and HRQOL remains underexplored in older adults with AF and multimorbidity, despite the high prevalence of PIP. Effective pharmacotherapy should be coupled with a comprehensive assessment of patients' clinical and functional parameters, considering their HRQOL. Adopting a multidisciplinary, integrated, patient-centred approach is essential for sustainable and appropriate prescribing practices and may enhance HRQOL.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"1137-1161"},"PeriodicalIF":3.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Which screening tool performs best in identifying malnutrition risk among hospitalized older adults with cardiovascular disease? A diagnostic accuracy study comparing six different screening tools with GLIM criteria.","authors":"Kevser Tarı Selcuk, Sedat Arslan, Ayça Aydın, Duygu Durmaz","doi":"10.1007/s41999-025-01187-y","DOIUrl":"10.1007/s41999-025-01187-y","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare the performance of six different screening tools with the GLIM criteria in identifying malnutrition risk among older adults with cardiovascular diseases.</p><p><strong>Methods: </strong>In this diagnostic accuracy study, data from 669 patients aged 65 and older, hospitalized at Bandırma Training and Research Hospital diagnosed with cardiovascular disease, were evaluated. The data were obtained using a questionnaire that included a Demographic Information Form, Global Leadership Initiative on Malnutrition (GLIM) Criteria, Malnutrition Screening Tool (MST), Malnutrition Universal Screening Tool (MUST), Short Nutritional Assessment Questionnaire (SNAQ), Mini Nutritional Assessment-Short Form (MNA-SF), Nutritional Risk Screening-2002 (NRS-2002), and Graz Malnutrition Screening (GMS) tool. GLIM criteria were used as gold standard and six screening tools were used as index tests. Receiver Operating Characteristic (ROC) curve analysis was conducted to calculate the Area Under the Curve (AUC), and the sensitivity, specificity, accuracy, and Cohen's Kappa (κ) coefficient of the index tests were assessed.</p><p><strong>Results: </strong>The mean age of the patients was 75.5 ± 7.7 years, 55.2% were female. According to the GLIM criteria, the prevalence of malnutrition was calculated as 22.0%. The AUC calculated by ROC indicated that MST (AUC: 0.905) had excellent predictive value, while MUST (AUC: 0.874), SNAQ (AUC: 0.851), MNA-SF (AUC: 0.842), and GMS (AUC: 0.820) demonstrated good predictive value. Among the screening tools, GMS had the highest sensitivity (92.5%), whereas MNA-SF exhibited the highest specificity (91.6%). MNA-SF also demonstrated the highest agreement with the GLIM criteria (Cohen's κ: 66.8) and the highest accuracy (88.3%).</p><p><strong>Conclusion: </strong>This study found that the MNA-SF tool outperformed other comprehensive screening tools when evaluating malnutrition risk in light of the GLIM criteria.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"1493-1505"},"PeriodicalIF":3.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Communicating prognostic uncertainties in advanced multimorbidity: a multimethod qualitative study to co-design practice recommendations.","authors":"Simon Noah Etkind, Rosanna Fennessy, James Wang, Rhian M Simpson, Bernadette O'Neill, Stephen I G Barclay, Anna Spathis","doi":"10.1007/s41999-025-01228-6","DOIUrl":"10.1007/s41999-025-01228-6","url":null,"abstract":"<p><strong>Purpose: </strong>Older adults with advanced multimorbidity face an uncertain future due to their unpredictable illness trajectory. Communication of such uncertainty is a core task in healthcare, but there is a limited evidence base to support communication of prognostic uncertainty in multimorbidity. We aimed to co-design clinical practice recommendations for communication of prognostic uncertainty in advanced multimorbidity, based on the lived experience and expertise of patients, carers, and healthcare professionals.</p><p><strong>Methods: </strong>Multi-method qualitative co-design study. In phase one, older adults with advanced multimorbidity, their informal carers, and health professionals participated in interviews and focus groups exploring experiences of uncertainty communication. Transcripts were analysed thematically. In phase two, attendees at two stakeholder events provided feedback on the findings and iteratively developed practice recommendations.</p><p><strong>Results: </strong>Fifteen older adults (median age 80, range 70-89), three informal carers, and 17 health professionals provided qualitative data. We then held workshops with 56 stakeholders. Participants considered that a personalised approach supported discussions of prognostic uncertainty; trusting care relationships, and regard for timing and preparation of all parties were needed. Participants agreed that discussions of uncertainty should proceed based on open and honest discussion within negotiated limits. Clinicians should signpost support and undertake parallel planning for the range of future possibilities to outline the boundaries of uncertainty.</p><p><strong>Conclusion: </strong>This study has developed recommendations for communication of prognostic uncertainty in older people with advanced multimorbidity, to support parallel planning for an unpredictable future. Implementing these recommendations, it may reduce negative impacts of uncertainty and improve care experience.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"1217-1229"},"PeriodicalIF":3.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low five-repetition chair stand test and usual gait speed scores predict falls within one year in an outpatient clinic for frailty.","authors":"Koki Kawamura, Taku Iwase, Shota Ishino, Yuto Nakao, Hitoshi Kagaya, Hiroyasu Akatsu, Hidenori Arai","doi":"10.1007/s41999-025-01233-9","DOIUrl":"10.1007/s41999-025-01233-9","url":null,"abstract":"<p><strong>Purpose: </strong>Falls in older adults increase the risk of mortality and hospitalization, particularly when physical function is low. This study aimed to determine whether low physical function and muscle mass, are also valuable for predicting falls within one year in older patients who visited an outpatient clinic for frailty.</p><p><strong>Methods: </strong>This prospective cohort study analyzed the registry data of 624 outpatients aged > 65 years (mean age: 77.9 ± 6.0 years; female 368, male 256). The endpoint was the incidence of falls within one year. These included the five-chair standing test (5CS), usual gait speed, short physical performance battery, handgrip strength, and skeletal muscle mass index. All of these tests were performed during the first clinic appointment. The question about fall history was asked one year after the examination, and the history of falls during the period of one year from the date of the examination. We analyzed the relationship between whether these assessments were below the cutoff values and falls within one year using multiple logistic regression analysis.</p><p><strong>Results: </strong>A total of 154 (25%) patients fell within one year. Those with a low result on the 5CS or usual gait speed had significantly higher rates of falls within one year, even after adjustment for covariates, with odds ratios [95% confidence interval] of 2.07 [1.37-3.13] and 1.68 [1.09-2.60], respectively.</p><p><strong>Conclusion: </strong>Low physical function, particularly in the lower limbs, was associated with near-term fall risk. The 5CS is helpful in fall risk assessment.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"1295-1302"},"PeriodicalIF":3.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the hospital frailty risk score in China.","authors":"Yue Qiu, Weiqing Xiong, Xinyue Fang, Pei Li, Simon Conroy, Laia Maynou, Kenneth Rockwood, Xien Liu, Ji Wu, Andrew Street","doi":"10.1007/s41999-025-01212-0","DOIUrl":"10.1007/s41999-025-01212-0","url":null,"abstract":"<p><strong>Purpose: </strong>To validate the Hospital Frailty Risk Score (HFRS) in Chinese hospital settings, describing how patients are allocated to frailty risk groups and how frailty risk is associated with length of stay (LoS) and hospital costs.</p><p><strong>Design: </strong>Retrospective observational study.</p><p><strong>Setting: </strong>Forty-eight hospitals in Lvliang City, Shanxi Province, China.</p><p><strong>Subjects: </strong>Patients aged 75 years or older hospitalised between 1 January 2022 and 31 December 2023 (n = 34,731).</p><p><strong>Methods: </strong>A logistic regression model examined the association between long length of stay (LoS) and frailty risk. A generalised linear model assessed the association between hospital costs and frailty risk. Subgroup analyses of age group, sex, and hospital tiers were conducted.</p><p><strong>Results: </strong>22.2% of patients were categorised as having zero risk, 62.4% as low risk, 15.3% as intermediate risk, and 0.08% as high risk. Compared to the zero risk group: for those with low risk, the probability of long LoS was 1.92 (95% CI 1.79-2.06) times higher and hospital costs were ¥1926 (95% CI 1655-2197) higher; for those with intermediate risk, the probability of long LoS was 2.7 (95% CI 2.49-2.96) times higher and hospital costs were ¥4284 (95% CI 3916-4653) higher; and for those with high risk, the probability of long LoS was 6.7 (95% CI 3.06-14.43) times higher and hospital costs were ¥16,613 (95% CI 12,827-20,399) higher. The explanatory power of the HFRS held across subgroups.</p><p><strong>Conclusions: </strong>Compared to patients aged 75 + elsewhere, those in China had lower frailty risk scores, likely reflecting a younger age structure and recording of fewer diagnosis codes. Even so, the HFRS is a powerful predictor of long length of stay and hospital costs in China.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"1319-1328"},"PeriodicalIF":3.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}