Frailty assessment, hip fracture and long‐term clinical outcomes in older adults. (23rd December 2020)

• Record Type: Journal Article
• Authors: Pizzonia, Monica; Giannotti, Chiara; Carmisciano, Luca; Signori, Alessio; Rosa, Gianmarco; Santolini, Federico; Caffa, Irene; Montecucco, Fabrizio; Nencioni, Alessio; Monacelli, Fiammetta
• Is Part Of: European journal of clinical investigation. Volume 51:Number 4(2021)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2020-12-23
• Subjects: frailty -- hip fracture -- long‐term mortality predictors -- older adults -- surgery; Pathology -- Periodicals; Medical research -- Periodicals; 616.075
• DOI: 10.1111/eci.13445
• Languages: English
• ISSNs: 0014-2972

Abstract

Abstract: Background: The primary aim of the study was determining the validation of the modified 19‐item Frailty Index (mFI‐19), based on the standard procedure for creating a frailty index scoring in the accumulation deficit theory of Rockwood and comparing it with the gold standard comprehensive geriatric assessment (CGA) in old age patients with hip fracture. As a secondary aim, we compared prognostic accuracies of mFI‐19 and CGA in predicting long‐term mortality after surgery. Materials and Methods: A total of 364 older patients with hip fractures, each a candidate for surgery, were consecutively enrolled. All were subjected to CGA and mFI‐19 at baseline and time to death (years from hip surgery) were collected prospectively. Results: Mean patient age was 86.5 (SD: 5.65) years. The most common clinical phenotype (77%) was frail. Both CGA and mFI‐19 performed similarly in predicting long‐term mortality (Harrell's C‐index: 0.66 and 0.68, respectively). Conclusions: The mFI‐19 was validated, compared to the gold standard CGA, based on a systematic process for creating a frailty index in relation to the accumulation deficit. This is one of few prospective studies addressing long‐term mortality in older adults with hip fractures, invoking a methodologically robust frailty screening assessment.