External validation of the hospital frailty risk score among hospitalised home care clients in Canada: a retrospective cohort study.
Background The Hospital Frailty Risk Score (HFRS) is scored using ICD-10 diagnostic codes in administrative hospital records. Home care clients in Canada are routinely assessed with Resident Assessment Instrument-Home Care (RAI-HC) which can calculate the Clinical Frailty Scale (CFS) and the Frailty...
| Publicado en: | Age & Ageing Vol. 52; no. 2; pp. 1 - 10 |
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| Autores principales: | , , , , , , , , , , |
| Formato: | Artículo |
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Oxford University Press / USA
Feb2023
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=162161656&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 162161656 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Feb2023 vid: 52 iid: 2 pid: 622 pub: Oxford University Press / USA artinfo: ui: 162161656 10.1093/ageing/afac334 ppf: 1 ppct: 9 formats: tig: atl: External validation of the hospital frailty risk score among hospitalised home care clients in Canada: a retrospective cohort study. aug: au: Turcotte, Luke Andrew Heckman, George Rockwood, Kenneth Vetrano, Davide Liborio Hébert, Paul McIsaac, Daniel I Rhynold, Elizabeth Mitchell, Lori Mowbray, Fabrice Immanuel Larsen, Rasmus T Hirdes, John P affil: School of Public Health Sciences, University of Waterloo , Waterloo, Ontario , Canada Department of Medicine, Dalhousie University and Nova Scotia Health , Halifax, Nova Scotia , Canada Aging Research Center , Department of Neurobiology, Care Sciences and Society, Karolinska Institute and Stockholm University, Stockholm, Sweden, & Stockholm Gerontology Research Center , Stockholm , Sweden Université de Montréal et Centre Hospitalier de l'Université de Montréal , Montréal , Canada Departments of Anesthesiology & Pain Medicine, University of Ottawa, and The Ottawa Hospital; School of Epidemiology & Public Health, University of Ottawa , Ottawa, Ontario , Canada Section of Geriatric Medicine, University of Manitoba and Prairie Mountain Health , Manitoba , Canada Home Care Program, Winnipeg Regional Health Authority , Winnipeg, Manitoba , Canada Department of Health Research Methods , Evidence, and Impact, McMaster University , Hamilton, Ontario , Canada Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital , Copenhagen , Denmark su: Canada Home care services Mortality Retrospective studies Hospital care of older people Length of stay in hospitals Statistics Frail elderly Confidence intervals Research methodology evaluation Patient readmissions Risk assessment Independent living Descriptive statistics Research funding Receiver operating characteristic curves Statistical correlation Data analysis Logistic regression analysis Data analysis software Longitudinal method Long-term health care Proportional hazards models sug: subj: Home care services Mortality Retrospective studies Hospital care of older people Canada Services for the Elderly and Persons with Disabilities Home Health Care Services Offices of all other health practitioners Offices of All Other Miscellaneous Health Practitioners Length of stay in hospitals Statistics Frail elderly Confidence intervals Research methodology evaluation Patient readmissions Risk assessment Independent living Descriptive statistics Research funding Receiver operating characteristic curves Statistical correlation Data analysis Logistic regression analysis Data analysis software Longitudinal method Long-term health care Proportional hazards models keyword: frailty hospitalisation older adults older people risk assessment frailty hospitalisation older adults older people risk assessment ab: Background The Hospital Frailty Risk Score (HFRS) is scored using ICD-10 diagnostic codes in administrative hospital records. Home care clients in Canada are routinely assessed with Resident Assessment Instrument-Home Care (RAI-HC) which can calculate the Clinical Frailty Scale (CFS) and the Frailty Index (FI). Objective Measure the correlation between the HFRS, CFS and FI and compare prognostic utility for frailty-related outcomes. Design Retrospective cohort study. Setting Alberta, British Columbia and Ontario, Canada. Subjects Home care clients aged 65+ admitted to hospital within 180 days (median 65 days) of a RAI-HC assessment (n = 167,316). Methods Correlation between the HFRS, CFS and FI was measured using the Spearman correlation coefficient. Prognostic utility of each measure was assessed by comparing measures of association, discrimination and calibration for mortality (30 days), prolonged hospital stay (10+ days), unplanned hospital readmission (30 days) and long-term care admission (1 year). Results The HFRS was weakly correlated with the FI (ρ 0.21) and CFS (ρ 0.28). Unlike the FI and CFS, the HFRS was unable to discriminate for 30-day mortality (area under the receiver operator characteristic curve (AUC) 0.506; confidence interval (CI) 0.502–0.511). It was the only measure that could discriminate for prolonged hospital stay (AUC 0.666; CI 0.661–0.673). The HFRS operated like the FI and CFI when predicting unplanned readmission (AUC 0.530 CI 0.526–0.536) and long-term care admission (AUC 0.600; CI 0.593–0.606). Conclusions The HFRS identifies a different subset of older adult home care clients as frail than the CFS and FI. It has prognostic utility for several frailty-related outcomes in this population, except short-term mortality. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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