title: Significance of frailty for predicting adverse clinical outcomes in different patient groups with specific medical conditions.
abstract: Frailty is a major health burden in an aging society. It constitutes a clinical state of reduced physiological reserves that is associated with a diminished ability to withstand internal and external stressors. Frail patients have an increased risk for adverse clinical outcomes, such as mortality, readmission to hospital, institutionalization and falls. Of further clinical interest, frailty might be at least in part reversible in some patients and subject to preventive strategies. In daily clinical practice older patients with a complex health status, who are mostly frail or at least at risk of developing frailty, are frequently cared for by geriatricians. Recently, clinicians and scientists from other medical disciplines, such as cardiology, pulmonology, gastroenterology, nephrology, endocrinology, rheumatology, surgery and critical care medicine also discovered frailty to be an interesting instrument for risk stratification of patients, including younger patients. In this review we highlight the results of recent studies that demonstrated the significance of frailty to predict adverse clinical outcomes in patients with specific medical conditions, such as cardiac, lung, liver and kidney diseases as well as diabetes mellitus, osteoarthritis, trauma patients, patients undergoing surgery and critically ill patients. Multiple studies in patients with the aforementioned specific medical conditions could be identified demonstrating a predictive role of frailty for several adverse clinical outcomes. The association between frailty and adverse clinical outcomes reported in these studies was in part independent of several major potential confounder factors, such as age, sex, race, comorbidities and disabilities and were also detected in younger patients.
authors.affiliation: Department of Internal Medicine III (Medicine of Ageing), Geriatrics Centre Erlangen, Hospital of the Congregation of St. Francis Sisters of Vierzehnheiligen, Rathsberger Straße 57, 91054, Erlangen, Germany. Martin.Ritt@waldkrankenhaus.de.|Institute for Biomedicine of Ageing (IBA), Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Kobergerstraße 60, 90408, Nürnberg, Germany. Martin.Ritt@waldkrankenhaus.de.
authors.forename: Martin
authors.initials: M
authors.lastname: Ritt
authors.affiliation: Department of Internal Medicine III (Medicine of Ageing), Geriatrics Centre Erlangen, Hospital of the Congregation of St. Francis Sisters of Vierzehnheiligen, Rathsberger Straße 57, 91054, Erlangen, Germany.|Institute for Biomedicine of Ageing (IBA), Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Kobergerstraße 60, 90408, Nürnberg, Germany.
authors.forename: Karl-Günter
authors.initials: KG
authors.lastname: Gaßmann
authors.affiliation: Institute for Biomedicine of Ageing (IBA), Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Kobergerstraße 60, 90408, Nürnberg, Germany.|Department of Internal Medicine and Geriatrics, Hospital of the Order of St. John of God, Prüfeninger Straße 86, 93049, Regensburg, Germany.
authors.forename: Cornel Christian
authors.initials: CC
authors.lastname: Sieber
mesh_terms: D000058:Accidental Falls / Q000401:mortality; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000401:mortality*; D002908:Chronic Disease / Q000401:mortality*; D015897:Comorbidity; D048909:Diabetes Complications / Q000401:mortality*; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality*; D008297:Male; D011379:Prognosis; D018570:Risk Assessment / Q000379:methods; D015996:Survival Rate; D014947:Wounds and Injuries / Q000401:mortality*
keywords: Clinical frailty scale; Comorbidities; Frail elderly; Mortality; Phenotype