The impact of frailty on prolonged hospitalization and mortality in elderly inpatients in Vietnam: a comparison between the frailty phenotype and the Reported Edmonton Frail Scale

Abstract

Aims

To investigate the impact of frailty on outcomes in older hospitalized patients, including prolonged length of stay and all-cause mortality 6 months after admission, using both the frailty phenotype and the Reported Edmonton Frail Scale (REFS).

Patients and methods

This study is the follow-up phase of a study designed to investigate the prevalence of frailty and its impact on adverse outcomes in older hospitalized patients at the National Geriatric Hospital in Hanoi, Vietnam.

Results

A total of 461 participants were included, with a mean age 76.2±8.9 years, and 56.8% were female. The prevalence of frailty was 31.9% according to the REFS and 35.4% according to Fried’s criteria. The kappa coefficient was 0.57 (95% CI =0.49–0.66) between the two frailty criteria in identifying frail and non-frail participants. There was a trend toward increasing the likelihood of prolonged hospitalization in participants with frailty defined by Fried’s criteria (adjusted OR =1.49, 95% CI =0.94–2.35) or by REFS (adjusted OR =1.43, 95% CI =0.89–2.29). During 6 months of follow-up, 210 were lost and 18/251 (7.2%) participants died. Mortality was higher in those with frailty defined by either Fried’s criteria or REFS. On multivariable survival analysis, adjusted HRs for mortality were 2.65 (95% CI =1.02–6.89) for Fried’s criteria and 4.19 (95% CI =1.59–10.99) for REFS.

Conclusion

Fried’s frailty phenotype or REFS can be used as a screening tool to detect frailty in older inpatients in Vietnam and predict mortality. Frailty screening can help prioritize targeted frailty-tailored treatments, such as nutrition, early mobility and medication review, for these vulnerable patients to improve clinical outcomes.

Keywords:

• frailty
• elderly
• inpatients
• Vietnam

Acknowledgments

We gratefully appreciate all staff at the in-patient departments, National Geriatric Hospital, and the participants in this study for their patience, time and interest.

Author contributions

ATN, TXN, TNN, HTTV and TP designed the research study. ATN, TXN, THTN, TNN and HTTV designed and developed the recruitment. TP is the research project manager. HTTV, TXN, THTN, ATN, TNN, RC, SNH and TP were involved in the design of the outcome evaluation. All authors were involved in project management and contributed to the drafting of the journal article, data analysis, critically revising the paper, gave final approval of the version to be published, and agreed to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.

Supplementary material

Table S1 Univariate logistic regression of potential predictor factors for prolonged hospitalization and mortality at the sixth month