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Frailty Assessment in Hospitalized Older Adults Using the Electronic Health Record.

Publication ,  Journal Article
Lekan, DA; Wallace, DC; McCoy, TP; Hu, J; Silva, SG; Whitson, HE
Published in: Biol Res Nurs
March 2017

INTRODUCTION: Frailty, a clinical syndrome of decreased physiologic reserve and dysregulation in multiple physiologic systems, is associated with increased risk for adverse outcomes. PURPOSE: The aim of this retrospective, cross-sectional, correlational study was to characterize frailty in older adults admitted to a tertiary-care hospital using a biopsychosocial frailty assessment and to determine associations between frailty and time to in-hospital mortality and 30-day rehospitalization. METHODS: The sample included 278 patients ≥55 years old admitted to medicine units. Frailty was determined using clinical data from the electronic health record (EHR) for symptoms, syndromes, and conditions and laboratory data for four serum biomarkers. A frailty risk score (FRS) was created from 16 risk factors, and relationships between the FRS and outcomes were examined. RESULTS: The mean age of the sample was 70.2 years and mean FRS was 9.4 ( SD, 2.2). Increased FRS was significantly associated with increased risk of death (hazard ratio = 1.77-2.27 for 3 days ≤ length of stay (LOS) ≤7 days), but depended upon LOS ( p < .001). Frailty was marginally associated with rehospitalization for those who did not die in hospital (adjusted odds ratio = 1.18, p = .086, area under the curve [AUC] = 0.66, 95% confidence interval for AUC = [0.57, 0.76]). DISCUSSION: Clinical data in the EHR can be used for frailty assessment. Informatics may facilitate data aggregation and decision support. Because frailty is potentially preventable and treatable, early detection is crucial to delivery of tailored interventions and optimal patient outcomes.

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Published In

Biol Res Nurs

DOI

EISSN

1552-4175

Publication Date

March 2017

Volume

19

Issue

2

Start / End Page

213 / 228

Location

United States

Related Subject Headings

  • Tertiary Care Centers
  • Southeastern United States
  • Risk Assessment
  • Retrospective Studies
  • Nursing
  • Middle Aged
  • Male
  • Length of Stay
  • Humans
  • Hospitalization
 

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Lekan, D. A., Wallace, D. C., McCoy, T. P., Hu, J., Silva, S. G., & Whitson, H. E. (2017). Frailty Assessment in Hospitalized Older Adults Using the Electronic Health Record. Biol Res Nurs, 19(2), 213–228. https://doi.org/10.1177/1099800416679730
Lekan, Deborah A., Debra C. Wallace, Thomas P. McCoy, Jie Hu, Susan G. Silva, and Heather E. Whitson. “Frailty Assessment in Hospitalized Older Adults Using the Electronic Health Record.Biol Res Nurs 19, no. 2 (March 2017): 213–28. https://doi.org/10.1177/1099800416679730.
Lekan DA, Wallace DC, McCoy TP, Hu J, Silva SG, Whitson HE. Frailty Assessment in Hospitalized Older Adults Using the Electronic Health Record. Biol Res Nurs. 2017 Mar;19(2):213–28.
Lekan, Deborah A., et al. “Frailty Assessment in Hospitalized Older Adults Using the Electronic Health Record.Biol Res Nurs, vol. 19, no. 2, Mar. 2017, pp. 213–28. Pubmed, doi:10.1177/1099800416679730.
Lekan DA, Wallace DC, McCoy TP, Hu J, Silva SG, Whitson HE. Frailty Assessment in Hospitalized Older Adults Using the Electronic Health Record. Biol Res Nurs. 2017 Mar;19(2):213–228.
Journal cover image

Published In

Biol Res Nurs

DOI

EISSN

1552-4175

Publication Date

March 2017

Volume

19

Issue

2

Start / End Page

213 / 228

Location

United States

Related Subject Headings

  • Tertiary Care Centers
  • Southeastern United States
  • Risk Assessment
  • Retrospective Studies
  • Nursing
  • Middle Aged
  • Male
  • Length of Stay
  • Humans
  • Hospitalization