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Study shows frailty a risk factor for hospital readmission, death

Frail patients who are discharged from the hospital have an increased risk of readmission or death within 30 days compared with patients who are not considered frail, according to recently published data. 

“Frailty was common and associated with a substantially increased risk of early readmission or death after discharge,” Finlay A. McAlister, MD, MSc, of the University of Alberta, and colleagues wrote.

To assess the correlation between frailty following hospital discharge with readmission or death within 30 days, researchers evaluated 495 patients from seven various medical wards at two hospitals. Patient frailty was determined using the Clinical Frailty Scale, and study participants were considered frail if their score was 5 or above. 

Overall, 32.7% of participants were considered frail, with 18% having mild, 12% having moderate and 2% having severe frailty. Patients who were frail were more likely to be older women, with more comorbidities and more hospital admissions in the previous year, compared with patients who were not frail.

Among all study participants, 85 were readmitted to the hospital, or died, within 30 days of discharge. Frail patients were more likely to be readmitted or die within 30 days of discharge, compared with non-frail patients (24.1% vs. 13.8%; OR = 2.01; 95% CI, 1.19-3.41). Both moderate and severe frailty was considered independent risk factors for death and readmission (31% event rate; OR = 2.19; 95% CI, 1.12-4.24).

The researchers noted that frailty may just be one of many reasons for hospital readmissions, and that identification of other risk factors and high-risk patients is vital for reducing readmission rates.

“Although frailty or vulnerability before becoming ill may affect outcomes after discharge, patients in hospital may also experience an acquired, transient period of risk for adverse events that are harmful in addition to the stress of an acute illness. Patients who are already frail before hospital admission may be more sensitive to the stresses of [post-hospital syndrome] and at higher risk of readmission and poor outcomes,” McAlister and colleagues wrote. – by Casey Hower

Disclosure: The researchers report no relevant financial disclosures.