Predicting the prevalence and outcomes of frailty through ICD-10 in older adults: experiences from a regional hospital in Taiwan

Background

In acute care hospitals, nearly 50% of hospitalised patients aged 65 and over suffer from frailty, which significantly affects their health outcomes.

Aims

Using a regional hospital as an example, we utilised the Hospital Frailty Risk Score (HFRS) to investigate the risk of frailty in Taiwanese older patients and to predict its impact on medical costs, hospital stays and mortality rates.

Methods

Data from hospital medical records were extracted, and 16 775 patients aged ≥65 years hospitalised between January 2019 and December 2021 were included. International Classification of Diseases, Tenth Revision (ICD-10) data for each inpatient were collected and weighted. The risk of frailty was defined according to the HFRS.

Results

The prevalence of moderate to high frailty risk was 54.1%, of which 43.6% were moderate risk and 10.5% were high risk. Those identified as having a moderate or high risk of frailty were males, of advanced age, with pneumonia and sepsis. Internal medicine patients had a higher rate of moderate to high risk of frailty than surgical patients. Patients with moderate or high frailty risk usually experienced more intensive care unit stays and had higher re-admission rates and medical costs. Moreover, high-risk patients had a greater chance of mortality at 30-day/90-day and 1-year intervals than low-risk patients.

Conclusions

More than half of older patients admitted to hospitals have a moderate to high risk of frailty. Utilising ICD-10 weights to assess frailty risk is a feasible strategy to reduce the workload of medical personnel and identify patients at risk of frailty at an earlier stage.