Prediction of one-year mortality by five different frailty instruments: A comparative study in hospitalized geriatric patients.
Data comparing the ability of different major frailty instruments for predicting mortality in hospitalized geriatric patients are scare.



307 patients ≥65years who were hospitalized on geriatric wards were included in this prospective analysis. A fifty-item frailty index (FI), a ten-domain+co-morbidity frailty index based on a standardized comprehensive geriatric assessment (FI-CGA), the nine category Clinical Frailty Scale (CFS-9), the CSHA rules-based frailty definition (CSHA-RBFD), and the frailty phenotype (FP) were assessed during the patients' hospital stays. Patients were followed up over a one-year period.



Follow-up data after one year could be obtained from 305 out of the 307 participants. Sixty two participants (20.3%) had died after that time. The FI, FI-CGA, CFS-9, CSHA-RBFD, and FP could all discriminate between patients who died and those who survived during follow-up (areas under the ROC curves: 0.805, 0.808, 0.852, 0.703 and 0.757, all P<0.001, respectively). The CFS-9 showed a better discriminative ability for one-year mortality compared to the FI, FI-CGA, CSHA-RBFD, and FP (all P<0.05, respectively). The FI and the FI-CGA did not differ in their discriminative ability for one-year mortality (P=0.440). The CSHA-RBFD and the FP demonstrated a comparable discriminative ability (P=0.241) and, when compared to the CFS-9, FI, and FI-CGA, an inferior discriminative ability for one-year mortality (all P<0.05, respectively).



Among those frailty instruments that were evaluated, the CFS-9 emerged as the most powerful for prediction of one-year mortality.
Institute for Biomedicine of Ageing (IBA), Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Kobergerstraße 60, D-90408 Nürnberg, Germany; Department of Internal Medicine III (Medicine of Ageing), Geriatrics Centre Erlangen, Hospital of the Congregation of St. Francis Sisters of Vierzehnheiligen, Rathsberger Straße 57, D-91054 Erlangen, Germany. Electronic address: Martin.Ritt@waldkrankenhaus.de.
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Ritt
Institute for Biomedicine of Ageing (IBA), Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Kobergerstraße 60, D-90408 Nürnberg, Germany; Department of Internal Medicine and Geriatrics, Hospital of the Order of St. John of God, Prüfeninger Straße 86, D-93049 Regensburg, Germany.
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Bollheimer
Institute for Biomedicine of Ageing (IBA), Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Kobergerstraße 60, D-90408 Nürnberg, Germany; Department of Internal Medicine and Geriatrics, Hospital of the Order of St. John of God, Prüfeninger Straße 86, D-93049 Regensburg, Germany.
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Sieber
Institute for Biomedicine of Ageing (IBA), Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Kobergerstraße 60, D-90408 Nürnberg, Germany; Department of Internal Medicine III (Medicine of Ageing), Geriatrics Centre Erlangen, Hospital of the Congregation of St. Francis Sisters of Vierzehnheiligen, Rathsberger Straße 57, D-91054 Erlangen, Germany.
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Gaßmann
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D015577:Geriatric Assessment; D005858:Germany / Q000453:epidemiology; D006333:Heart Failure / Q000453:epidemiology; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D009026:Mortality; D009203:Myocardial Infarction / Q000453:epidemiology; D011446:Prospective Studies; D012372:ROC Curve; D014549:Urinary Incontinence / Q000453:epidemiology
Frailty instruments; Hospitalized geriatric patients; Mortality