External validation of the hospital frailty risk score among hospitalised home care clients in Canada: a retrospective cohort study.

Autor:	Turcotte LA; School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada., Heckman G; School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada., Rockwood K; Department of Medicine, Dalhousie University and Nova Scotia Health, Halifax, Nova Scotia, Canada., Vetrano DL; Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institute and Stockholm University, Stockholm, Sweden, & Stockholm Gerontology Research Center, Stockholm, Sweden., Hébert P; Université de Montréal et Centre Hospitalier de l'Université de Montréal, Montréal, Canada., McIsaac DI; Departments of Anesthesiology & Pain Medicine, University of Ottawa, and The Ottawa Hospital; School of Epidemiology & Public Health, University of Ottawa, Ottawa, Ontario, Canada., Rhynold E; Section of Geriatric Medicine, University of Manitoba and Prairie Mountain Health, Manitoba, Canada., Mitchell L; Home Care Program, Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada., Mowbray FI; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada., Larsen RT; Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital, Copenhagen, Denmark., Hirdes JP; School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.
Jazyk:	angličtina
Zdroj:	Age and ageing [Age Ageing] 2023 Feb 01; Vol. 52 (2).
DOI:	10.1093/ageing/afac334
Abstrakt:	Background: The Hospital Frailty Risk Score (HFRS) is scored using ICD-10 diagnostic codes in administrative hospital records. Home care clients in Canada are routinely assessed with Resident Assessment Instrument-Home Care (RAI-HC) which can calculate the Clinical Frailty Scale (CFS) and the Frailty Index (FI). Objective: Measure the correlation between the HFRS, CFS and FI and compare prognostic utility for frailty-related outcomes. Design: Retrospective cohort study. Setting: Alberta, British Columbia and Ontario, Canada. Subjects: Home care clients aged 65+ admitted to hospital within 180 days (median 65 days) of a RAI-HC assessment (n = 167,316). Methods: Correlation between the HFRS, CFS and FI was measured using the Spearman correlation coefficient. Prognostic utility of each measure was assessed by comparing measures of association, discrimination and calibration for mortality (30 days), prolonged hospital stay (10+ days), unplanned hospital readmission (30 days) and long-term care admission (1 year). Results: The HFRS was weakly correlated with the FI (ρ 0.21) and CFS (ρ 0.28). Unlike the FI and CFS, the HFRS was unable to discriminate for 30-day mortality (area under the receiver operator characteristic curve (AUC) 0.506; confidence interval (CI) 0.502-0.511). It was the only measure that could discriminate for prolonged hospital stay (AUC 0.666; CI 0.661-0.673). The HFRS operated like the FI and CFI when predicting unplanned readmission (AUC 0.530 CI 0.526-0.536) and long-term care admission (AUC 0.600; CI 0.593-0.606). Conclusions: The HFRS identifies a different subset of older adult home care clients as frail than the CFS and FI. It has prognostic utility for several frailty-related outcomes in this population, except short-term mortality. (© The Author(s) 2023. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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