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Observational Study
. 2023 Apr;36(3):687-693.
doi: 10.1007/s40620-022-01532-5. Epub 2022 Dec 22.

Comparison between FRAIL Scale and Clinical Frailty Scale in predicting hospitalization in hemodialysis patients

Elisabete Mouzinho Soares Barbosa  1 , Amanda Gomes Pereira  1 , Vitória Mori  1 , Renan da Silva Neves  1 , Nayane Maria Vieira  1 , Maryanne Zilli Canedo Silva  1 , Marcos Mitsuo Seki  1 , Hellen Christina Neves Rodrigues  2 , Nara Aline Costa  3 , Daniela Ponce  1 , André Luís Balbi  1 , Leonardo Antonio Mamede Zornoff  1 , Paula Schmidt Azevedo  1 , Bertha Furlan Polegato  1 , Sérgio Alberto Rupp de Paiva  1 , Marcos Ferreira Minicucci  1 , Mariana de Souza Dorna  1
Affiliations
Observational Study

Comparison between FRAIL Scale and Clinical Frailty Scale in predicting hospitalization in hemodialysis patients

Elisabete Mouzinho Soares Barbosa et al. J Nephrol. 2023 Apr.

Abstract

Background: To assess the prevalence of frailty by the Clinical Frailty Scale (CFS) and the 5-item FRAIL scale and their association with hospitalization in hemodialysis (HD) patients.

Methods: This was a prospective observational study. We included patients of both genders ≥ 18 years old in HD treatment for at least 3 months. Demographic, clinical, and routine laboratory data were retrieved from the medical charts. Two different frailty assessment tools were used, the CFS and the FRAIL scale. Participants were followed up for 9 months and hospitalizations for all causes were evaluated. A Venn diagram was constructed to show the overlap of possible frailty and pre-frailty. Cox regression was used to identify the association between frailty and hospitalization. The significance level was 5%.

Results: A total of 137 subjects were included in the analysis. The median age was 61 (52-67) years and 60% were male. The hospitalization rate and mortality in 9 months were 22.6% and 7.29%, respectively. Regarding frailty, the overall prevalence was 13.8% assessed by CFS and 36.5% according to the FRAIL scale. In the Cox regression, frailty by FRAIL scale was associated with a 2.8-fold increase in the risk of hospitalization (OR = 2.880; 95% CI = 1.361-6.096; p = 0.006), but frailty assessed by the CFS was not associated with the need for hospitalization.

Conclusion: In HD patients, the FRAIL scale proved to be an easy-to-apply tool, identifying a high prevalence of frailty and being a predictor of hospital admission.

Keywords: Frailty; Hemodialysis; Hospitalization; Scales.

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Conflict of interest statement

None of the authors has any conflict to declare related to the present study.

Figures

Fig. 1
Fig. 1
Venn diagram showing the overlap of possible diagnosis of frailty and pre-fragile according to CFS and FRAIL scale. In red, are patients diagnosed with frailty; in black, pre-fragile patients; in blue, non-frail patients. The intersection of the circles represents patients who received the same diagnosis by CFS and FRAIL scale. CFS clinical Frail Scale, FRAIL Fatigue, Resistance, Ambulation, Illnesses, and Loss of Weight
See this image and copyright information in PMC

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