title: Comparing three different measures of frailty in medical inpatients: Multicenter prospective cohort study examining 30-day risk of readmission or death.
abstract: Multiple tools are used to identify frailty.
  
  
  
  To compare the global Clinical Frailty Scale (CFS) with more objective phenotypic tools (modified Fried score and the Timed Up and Go Test [TUGT]).
  
  
  
  Prospective cohort study.
  
  
  
  General medical wards in Edmonton, Canada.
  
  
  
  Adults being discharged back to the community.
  
  
  
  All frailty assessments were done within 24 hours of discharge. Patients were classified as frail if they scored ≥5 on the CFS and/or ≥3 on the modified Fried score, and/or had reduced mobility (>20 seconds on the TUGT). The main outcome was readmission or death within 30 days.
  
  
  
  Of 495 patients, 211 (43%) were frail according to at least 1 assessment, 46 (9%) met all 3 frailty definitions, and 17% died or were readmitted to the hospital within 30 days. Although patients classified as frail on the CFS exhibited significantly higher 30-day readmission/death rates (23% vs 14% for not frail, P = 0.005; 28% vs. 12% in the elderly, P < 0.001), even after adjusting for age and sex (adjusted odds ratio [aOR]: 2.02, 95% confidence interval [CI]: 1.19-3.41 for all adults; aOR: 3.20, 95% CI: 1.55-6.60 for the elderly), patients meeting either of the phenotypic definitions for frailty but not the CFS definition were not at higher risk of 30-day readmission/death (aOR: 0.87, 95% CI: 0.34-2.19 for all adults and aOR: 1.41, 95% CI: 0.72-2.78 for the elderly).
  
  
  
  Frailty has a significant impact on postdischarge outcomes, and the CFS is the most useful of the frequently used frailty tools for predicting poor outcomes after discharge. Journal of Hospital Medicine 2016;11:556-562. © 2016 Society of Hospital Medicine.
authors.affiliation: Division of General Internal Medicine, University of Alberta, Alberta, Edmonton, Alberta, Canada.
authors.forename: Sara
authors.initials: S
authors.lastname: Belga
authors.affiliation: Division of General Internal Medicine, University of Alberta, Alberta, Edmonton, Alberta, Canada.|Patient Health Outcomes Research and Clinical Effectiveness Unit, University of Alberta, Alberta, Edmonton, Canada.
authors.forename: Sumit R
authors.initials: SR
authors.lastname: Majumdar
authors.affiliation: Division of General Internal Medicine, University of Alberta, Alberta, Edmonton, Alberta, Canada.
authors.forename: Sharry
authors.initials: S
authors.lastname: Kahlon
authors.affiliation: Division of General Internal Medicine, University of Alberta, Alberta, Edmonton, Alberta, Canada.
authors.forename: Jenelle
authors.identifier: 0000-0001-7047-7590
authors.initials: J
authors.lastname: Pederson
authors.affiliation: Division of General Internal Medicine, University of Alberta, Alberta, Edmonton, Alberta, Canada.
authors.forename: Darren
authors.initials: D
authors.lastname: Lau
authors.affiliation: Division of General Internal Medicine, University of Alberta, Alberta, Edmonton, Alberta, Canada.|Patient Health Outcomes Research and Clinical Effectiveness Unit, University of Alberta, Alberta, Edmonton, Canada.
authors.forename: Raj S
authors.initials: RS
authors.lastname: Padwal
authors.affiliation: Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Alberta, Edmonton, Canada.
authors.forename: Mary
authors.initials: M
authors.lastname: Forhan
authors.affiliation: Patient Health Outcomes Research and Clinical Effectiveness Unit, University of Alberta, Alberta, Edmonton, Canada.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Bakal
authors.affiliation: Division of General Internal Medicine, University of Alberta, Alberta, Edmonton, Alberta, Canada.|Patient Health Outcomes Research and Clinical Effectiveness Unit, University of Alberta, Alberta, Edmonton, Canada.
authors.forename: Finlay A
authors.initials: FA
authors.lastname: McAlister
mesh_terms: D000368:Aged; D002170:Canada; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D010351:Patient Discharge; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011446:Prospective Studies; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D013997:Time Factors