We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Development of an Electronic Frailty Index for Hospitalized Older Adults in Sweden.
- Authors
Mak, Jonathan K L; Hägg, Sara; Eriksdotter, Maria; Annetorp, Martin; Kuja-Halkola, Ralf; Kananen, Laura; Boström, Anne-Marie; Kivipelto, Miia; Metzner, Carina; Jerlardtz, Viktoria Bäck; Engström, Malin; Johnson, Peter; Lundberg, Lars Göran; Åkesson, Elisabet; Öberg, Carina Sühl; Olsson, Maria; Cederholm, Tommy; Jylhävä, Juulia; Religa, Dorota; Bäck Jerlardtz, Viktoria
- Abstract
<bold>Background: </bold>Frailty assessment in the Swedish health system relies on the Clinical Frailty Scale (CFS), but it requires training, in-person evaluation, and is often missing in medical records. We aimed to develop an electronic frailty index (eFI) from routinely collected electronic health records (EHRs) and assess its association with adverse outcomes in hospitalized older adults.<bold>Methods: </bold>EHRs were extracted for 18 225 patients with unplanned admissions between 1 March 2020 and 17 June 2021 from 9 geriatric clinics in Stockholm, Sweden. A 48-item eFI was constructed using diagnostic codes, functioning and other health indicators, and laboratory data. The CFS, Hospital Frailty Risk Score, and Charlson Comorbidity Index were used for comparative assessment of the eFI. We modeled in-hospital mortality and 30-day readmission using logistic regression; 30-day and 6-month mortality using Cox regression; and length of stay using linear regression.<bold>Results: </bold>Thirteen thousand one hundred and eighty-eight patients were included in analyses (mean age 83.1 years). A 0.03 increment in the eFI was associated with higher risks of in-hospital (odds ratio: 1.65; 95% confidence interval: 1.54-1.78), 30-day (hazard ratio [HR]: 1.43; 1.38-1.48), and 6-month mortality (HR: 1.34; 1.31-1.37) adjusted for age and sex. Of the frailty and comorbidity measures, the eFI had the highest area under receiver operating characteristic curve for in-hospital mortality of 0.813. Higher eFI was associated with longer length of stay, but had a rather poor discrimination for 30-day readmission.<bold>Conclusions: </bold>An EHR-based eFI has robust associations with adverse outcomes, suggesting that it can be used in risk stratification in hospitalized older adults.
- Subjects
SWEDEN; RESEARCH funding; RETROSPECTIVE studies; GERIATRIC assessment; CHRONIC fatigue syndrome; ELECTRONICS
- Publication
Journals of Gerontology Series A: Biological Sciences & Medical Sciences, 2022, Vol 77, Issue 11, p2311
- ISSN
1079-5006
- Publication type
Article
- DOI
10.1093/gerona/glac069