Observational studyLancet (London, England)2018
Development and validation of a Hospital Frailty Risk Score focusing on older people in acute care settings using electronic hospital records: an observational study.
Observational study in Lancet (London, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06965972 (Prospective Cohort for the Study of Phenotypic Clusters, Progression Paths and Outcomes of Frailty and Dependence), which is not on this map. Cited by 809 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Prospective Cohort for the Study of Phenotypic Clusters, Progression Paths and Outcomes of Frailty and Dependence: The Spanish CohorFES
Who cites it
809 citing papers in PubMed.
- Trial
- Relative Effectiveness of High-Dose Versus Standard-Dose Influenza Vaccination Against Hospitalizations and Deaths According to Frailty Score: A Post Hoc Analysis of the DANFLU-1 Randomized Trial.The Journal of infectious diseases · 2026Trial
- Association of frailty indices with post-operative outcomes in shoulder surgery: a systematic review.JSES reviews, reports, and techniques · 2026Review
- Association of surgical strategy guided by Wu's classification with surgical outcomes in left-sided hepatocellular carcinoma patients with frailty.Surgical endoscopy · 2026Article
- Long-term incidence of infective endocarditis according to the type of cardiac implantable electronic device: a nationwide comparison with moderate- and high-risk patient groups.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026Article
- Associated prognostic impact of opioid use before Transcatheter aortic valve implantation - A Danish nationwide cohort study.International journal of cardiology. Heart & vasculature · 2026Article
- Inequalities in oral anticoagulant treatment patterns: a two-part model to estimate healthcare costs associated with atrial fibrillation.The European journal of health economics : HEPAC : health economics in prevention and care · 2026Article
- Temporal Trends in Mitral Valve Repair Procedures and Outcomes Among Older U.S. Adults.JACC. Advances · 2026Article
- Risk factors for long-term analgesic prescription after hip or knee arthroplasty for osteoarthritis: results of a multivariable regression analysis based on health insurance claims data from 137,875 patients with postoperative inpatient rehabilitation.BMC musculoskeletal disorders · 2026Article
- Integrating frailty and acute illness severity scoring for risk stratification in acute geriatric care: Review and practical guide.World journal of critical care medicine · 2026Review
- Article
- Impact of Cognitive Status at Skilled Nursing Facility Admission on Days Spent at Home Over the Year Following Traumatic Brain Injury Among Older Adults.Journal of the American Medical Directors Association · 2026Article
- Association Between Initiation of Cardiac Rehabilitation after Hospitalization for Heart Failure and 1-Year Survival Among Medicare Beneficiaries.Journal of general internal medicine · 2026Article
- Quality indicators for transcatheter aortic valve implantation in Ontario, Canada: a population-based study.BMJ open · 2026Article
- The rate of and risk factors for falls among patients with cirrhosis: A multicenter study.Hepatology communications · 2026Article
- Association Between Preoperative Frailty and Postoperative Acute Kidney Injury, Complications, and Resource Utilization in Older Patients Undergoing Hip Fracture Surgery.Geriatrics & gerontology international · 2026Article
- Historical Drug Costs Among Elderly Patients Hospitalized with Heart Failure in Canada, 2013-2014 to 2018-2019.CJC open · 2026Article
- In-hospital cardiac arrest in a Singaporean tertiary hospital: Epidemiology, outcomes, and potential suboptimal end-of-life planning.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2026Article
- Impact of Premorbid Function and Comorbidities in Geriatric Traumatic Brain Injury Patients: A Systematic Review.Cureus · 2026Review
- Vedolizumab vs TNF Antagonists and Long-Term Outcomes in Ulcerative Colitis.JAMA network open · 2026Article
749 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Commented on by
- Commented on by
- Commented on by
Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOlder people are increasing users of health care globally. We aimed to establish whether older people with characteristics of frailty and who are at risk of adverse health-care outcomes could be identified using routinely collected data.
methodsA three-step approach was used to develop and validate a Hospital Frailty Risk Score from International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) diagnostic codes. First, we carried out a cluster analysis to identify a group of older people (≥75 years) admitted to hospital who had high resource use and diagnoses associated with frailty. Second, we created a Hospital Frailty Risk Score based on ICD-10 codes that characterised this group. Third, in separate cohorts, we tested how well the score predicted adverse outcomes and whether it identified similar groups as other frailty tools.
findingsIn the development cohort (n=22 139), older people with frailty diagnoses formed a distinct group and had higher non-elective hospital use (33·6 bed-days over 2 years compared with 23·0 bed-days for the group with the next highest number of bed-days). In the national validation cohort (n=1 013 590), compared with the 429 762 (42·4%) patients with the lowest risk scores, the 202 718 (20·0%) patients with the highest Hospital Frailty Risk Scores had increased odds of 30-day mortality (odds ratio 1·71, 95% CI 1·68-1·75), long hospital stay (6·03, 5·92-6·10), and 30-day readmission (1·48, 1·46-1·50). The c statistics (ie, model discrimination) between individuals for these three outcomes were 0·60, 0·68, and 0·56, respectively. The Hospital Frailty Risk Score showed fair overlap with dichotomised Fried and Rockwood scales (kappa scores 0·22, 95% CI 0·15-0·30 and 0·30, 0·22-0·38, respectively) and moderate agreement with the Rockwood Frailty Index (Pearson's correlation coefficient 0·41, 95% CI 0·38-0·47).
interpretationThe Hospital Frailty Risk Score provides hospitals and health systems with a low-cost, systematic way to screen for frailty and identify a group of patients who are at greater risk of adverse outcomes and for whom a frailty-attuned approach might be useful.
fundingNational Institute for Health Research.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.