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Background <p>Frailty assessment is crucial for predicting outcomes in acute care settings; however, its application remains challenging. Therefore, this study aims to evaluate and compare two electronic medical record-based tools—the Canadian Institute for Health Information Hospital Frailty Risk Measure (CIHI-HFRM) and the United Kingdom Hospital Frailty Risk Score (UK-HFRS)—in older patients requiring urgent admission.</p> Methods <p>In this retrospective cohort study, we analyzed 35,564 patients aged 65 or older from the MIMIC-IV 2.0 database. Frailty was assessed using CIHI-HFRM and UK-HFRS. Primary outcomes included in-hospital mortality, one-year post-discharge mortality, post-discharge care needs, timely hospital discharge, and one-year readmission rates. Logistic regression, Cox regression, and competing risk models were used for analysis.</p> Results <p>The CIHI-HFRM and UK-HFRS were significantly associated with in-hospital mortality [odds ratio (OR) per point: CIHI-HFRM 1.10 (95% confidence interval (CI) 1.07–1.13); UK-HFRS 1.06 (95% CI 1.05–1.07)] and one-year post-discharge mortality [hazard ratio (HR) per point: CIHI-HFRM 1.08 (95% CI 1.06–1.09); UK-HFRS 1.05 (95% CI 1.04–1.05)]. Both measures were associated with prolonged hospital stays and post-discharge care needs, while only CIHI-HFRM was linked to one-year readmission risk.</p> Conclusion <p>The CIHI-HFRM and UK-HFRS effectively stratify adverse outcomes risk in older patients requiring urgent admission. They may be considered alongside traditional measures as part of a pragmatic multimodal pathway, which represents a potential direction for clinical application.</p>

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Comparison of two electronic medical record-based frailty assessment tools and their association with adverse outcomes in older hospitalized patients with urgent admissions

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月1日

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  • Benchuan Hao,
  • Yifei Xu,
  • Huimin Yang,
  • Liangchen Li,
  • Zhong Zhang,
  • Huihui Xia,
  • Dapeng Song,
  • Chaosheng Du,
  • Zhenzhen Yang,
  • Bei Zhao

摘要

Background

Frailty assessment is crucial for predicting outcomes in acute care settings; however, its application remains challenging. Therefore, this study aims to evaluate and compare two electronic medical record-based tools—the Canadian Institute for Health Information Hospital Frailty Risk Measure (CIHI-HFRM) and the United Kingdom Hospital Frailty Risk Score (UK-HFRS)—in older patients requiring urgent admission.

Methods

In this retrospective cohort study, we analyzed 35,564 patients aged 65 or older from the MIMIC-IV 2.0 database. Frailty was assessed using CIHI-HFRM and UK-HFRS. Primary outcomes included in-hospital mortality, one-year post-discharge mortality, post-discharge care needs, timely hospital discharge, and one-year readmission rates. Logistic regression, Cox regression, and competing risk models were used for analysis.

Results

The CIHI-HFRM and UK-HFRS were significantly associated with in-hospital mortality [odds ratio (OR) per point: CIHI-HFRM 1.10 (95% confidence interval (CI) 1.07–1.13); UK-HFRS 1.06 (95% CI 1.05–1.07)] and one-year post-discharge mortality [hazard ratio (HR) per point: CIHI-HFRM 1.08 (95% CI 1.06–1.09); UK-HFRS 1.05 (95% CI 1.04–1.05)]. Both measures were associated with prolonged hospital stays and post-discharge care needs, while only CIHI-HFRM was linked to one-year readmission risk.

Conclusion

The CIHI-HFRM and UK-HFRS effectively stratify adverse outcomes risk in older patients requiring urgent admission. They may be considered alongside traditional measures as part of a pragmatic multimodal pathway, which represents a potential direction for clinical application.