Hospital frailty risk score and adverse health outcomes: evidence from longitudinal record linkage cardiac data

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Nghiem, Son
Afoakwah, Clifford
Scuffham, Paul
Byrnes, Joshua
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2021
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Abstract

BACKGROUND: Despite recent evidence on the effect of frailty on health outcomes among those with heart failure, there is a dearth of knowledge on measuring frailty using administrative health data on a wide range of cardiovascular diseases (CVD). METHODS: We conducted a retrospective record-linkage cohort study of patients with diverse CVD in Queensland, Australia. We investigated the relationship between the risk of frailty, defined using the hospital frailty risk score (HFRS), and 30-day mortality, 30-day unplanned readmission, non-home discharge, length of hospital stay (LOS) at an emergency department and inpatient units and costs of hospitalisation. Descriptive analysis, bivariate logistic regression and generalised linear models were used to estimate the association between HFRS and CVD outcomes. Smear adjustment was applied to hospital costs and the LOS for each frailty risk groups. RESULTS: The proportion of low, medium and high risk of frailty was 24.6%, 34.5% and 40.9%, respectively. The odds of frail patients dying or being readmitted within 30 days of discharge was 1.73 and 1.18, respectively. Frail patients also faced higher odds of LOS, and non-home discharge at 3.1 and 2.25, respectively. Frail patients incurred higher hospital costs (by 42.7-55.3%) and stayed in the hospital longer (by 49%). CONCLUSION: Using the HFRS on a large CVD cohort, this study confirms that frailty was associated with worse health outcomes and higher healthcare costs. Administrative data should be more accessible to research such that the HFRS can be applied to healthcare planning and patient care.

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Age and Ageing
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© 2021 Australian Journal of Outdoor Education. This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Age and Ageing following peer review. The definitive publisher-authenticated version Hospital frailty risk score and adverse health outcomes: evidence from longitudinal record linkage cardiac data, Age and Ageing, 2021 is available online at: https://doi.org/10.1093/ageing/afab073.
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Health economics
Clinical sciences
Health services and systems
Applied and developmental psychology
Australia
adverse health outcomes
cardiovascular diseases
hospital frailty risk score
linkage data
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Nghiem, S; Afoakwah, C; Scuffham, P; Byrnes, J, Hospital frailty risk score and adverse health outcomes: evidence from longitudinal record linkage cardiac data, Age and Ageing, 2021
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