title: Association of the clinical frailty scale with hospital outcomes.
abstract: BACKGROUND
  The clinical frailty scale (CFS) was validated as a predictor of adverse outcomes in community-dwelling older people. In our hospital, the use of the CFS in emergency admissions of people aged ≥ 75 years was introduced under the Commissioning for Quality and Innovation payment framework.
  
  
  OBJECTIVE
  We retrospectively studied the association of the CFS with patient characteristics and outcomes.
  
  
  METHODS
  Retrospective observational study in a large tertiary university National Health Service hospital in UK.
  
  
  METHODS
  The CFS was correlated with transfer to specialist Geriatric ward, length of stay (LOS), in-patient mortality and 30-day readmission rate.
  
  
  RESULTS
  Between 1st August 2013 and 31st July 2014, there were 11 271 emergency admission episodes of people aged ≥ 75 years (all specialties), corresponding to 7532 unique patients (first admissions); of those, 5764 had the CFS measured by the admitting team (81% of them within 72 hr of admission). After adjustment for age, gender, Charlson comorbidity index and history of dementia and/or current cognitive concern, the CFS was an independent predictor of in-patient mortality [odds ratio (OR) = 1.60, 95% confidence interval (CI): 1.48 to 1.74, P < 0.001], transfer to Geriatric ward (OR = 1.33, 95% CI: 1.24 to 1.42, P < 0.001) and LOS ≥ 10 days (OR = 1.19, 95% CI: 1.14 to 1.23, P < 0.001). The CFS was not a multivariate predictor of 30-day readmission.
  
  
  CONCLUSIONS
  The CFS may help predict in-patient mortality and target specialist geriatric resources within the hospital. Usual hospital metrics such as mortality and LOS should take into account measurable patient complexity.
authors.affiliation: From the Department of Medicine for the Elderly, Addenbrooke's Hospital, Cambridge, UK, School of Clinical Medicine, University of Cambridge, Cambridge, UK and.
authors.forename: S J
authors.initials: SJ
authors.lastname: Wallis
authors.affiliation: School of Clinical Medicine, University of Cambridge, Cambridge, UK and.
authors.forename: J
authors.initials: J
authors.lastname: Wall
authors.affiliation: From the Department of Medicine for the Elderly, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: R W S
authors.initials: RW
authors.lastname: Biram
authors.affiliation: From the Department of Medicine for the Elderly, Addenbrooke's Hospital, Cambridge, UK, Clinical Gerontology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK roman.romero-ortuno@nhs.net.
authors.forename: R
authors.initials: R
authors.lastname: Romero-Ortuno
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004630:Emergencies; D004739:England; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment / Q000379:methods*; D006305:Health Status Indicators; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D017063:Outcome Assessment, Health Care; D010359:Patient Readmission / Q000706:statistics & numerical data; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies