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. 2023 Dec;27(4):315-323.
doi: 10.4235/agmr.23.0124. Epub 2023 Sep 25.

Frailty Screening and Detection of Geriatric Syndromes in Acute Inpatient Care: Impact on Hospital Length of Stay and 30-Day Readmissions

Justin Chew  1   2 , Jia Qian Chia  1   2 , Kay Khine Kyaw  1 , Katrielle Joy Fu  1 , Celestine Lim  1 , Shiyun Chua  1 , Huei Nuo Tan  1
Affiliations

Frailty Screening and Detection of Geriatric Syndromes in Acute Inpatient Care: Impact on Hospital Length of Stay and 30-Day Readmissions

Justin Chew et al. Ann Geriatr Med Res. 2023 Dec.

Abstract

Background: Frailty is prevalent in acute care and is associated with negative outcomes. While a comprehensive geriatric assessment to identify geriatric syndromes is recommended after identifying frailty, more evidence is needed to support this approach in the inpatient setting. This study examined the association between frailty and geriatric syndromes and their impact on outcomes in acutely admitted older adults.

Methods: A total of 733 individuals aged ≥65 years admitted to the General Surgery Service of a tertiary hospital were assessed for frailty using the Clinical Frailty Scale (CFS) and for geriatric syndromes using routine nursing admission assessments, including cognitive impairment, falls, incontinence, malnutrition, and poor oral health. Multinomial logistic regression and Cox regression were used to evaluate the associations between frailty and geriatric syndromes and their concomitant impact on hospital length of stay (LOS) and 30-day readmissions.

Results: Greater frailty severity was associated with an increased likelihood of geriatric syndromes. Individuals categorized as CFS 4-6 and CFS 7-8 with concomitant geriatric syndromes had 29% and 35% increased risks of a longer LOS, respectively. CFS 4-6 was significantly associated with functional decline (relative risk ratio =1.46; 95% confidence interval [CI], 1.03-2.07) and 30-day readmission (hazare ratio=1.78; 95% CI, 1.04-3.04), whereas these associations were not significant for CFS 7-8.

Conclusion: Geriatric syndromes in frail individuals can be identified from routine nursing assessments and represent a potential approach for targeted interventions following frailty identification. Tailored interventions may be necessary to achieve optimal outcomes at different stages of frailty. Further research is required to evaluate interventions for older adults with frailty in a wider hospital context.

Keywords: Frailty; Geriatric assessment; Hospitalization; Inpatients; Outcome assessment; Syndrome.

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Conflict of interest statement

CONFLICT OF INTEREST

The researchers claim no conflicts of interest.

Figures

Fig. 1.
Fig. 1.
Geriatric syndromes by Clinical Frailty Scale (CFS) levels: (A) functional decline, (B) recurrent falls, (C) cognitive impairment, (D) malnutrition risk, (E) poor oral health, and (F) bladder or bowel incontinence.
Fig. 2.
Fig. 2.
Multinomial logistic regression for the association between Clinical Frailty Scale (CFS) levels and geriatric syndromes: (A) CFS 4–6 and (B) CFS 7–8.
See this image and copyright information in PMC

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