ArticleJournal of the American Geriatrics Society2021
Automated Frailty Screening At-Scale for Pre-Operative Risk Stratification Using the Electronic Frailty Index.
Article in Journal of the American Geriatrics Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 1 of them a synthesis that pooled it.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
38 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Frailty Screening Using the Risk Analysis Index: A User Guide.Joint Commission journal on quality and patient safety · 2025Pooled it
- Relative impact of multidomain lifestyle interventions on deficit accumulation frailty over 24 months in the U.S. POINTER trial.The journals of gerontology. Series A, Biological sciences and medical sciences · 2026Trial
- Hearing Aid Use Attenuates the Association Between Hearing Loss and Frailty: A 2003-2018 NHANES Cross Sectional Analysis.Journal of the American Geriatrics Society · 2026Article
- Comparison of Electronic Health Data-Based Frailty Assessment Tools for Prediction of Adverse Outcomes of Patients With Chronic Kidney Disease.Nephrology (Carlton, Vic.) · 2026Article
- Frailty as an indicator of adverse health outcomes in rheumatoid arthritis: a multicenter cross-sectional study.Arthritis research & therapy · 2026Article
- Challenges and strategies in the care of older adults across the continuum of intensive and post-intensive care medicine.Intensive care medicine · 2026Review
- External validation of an AI-based preoperative frailty index using real-world data.The journals of gerontology. Series A, Biological sciences and medical sciences · 2025Article
- A Large Language Model Approach to Identifying Preoperative Frailty Among Older Adults From Clinical Notes.Journal of the American Geriatrics Society · 2025Article
- Treatment outcomes in older patients presenting to a radiation oncology clinic based on an electronic health record-based frailty index.Journal of geriatric oncology · 2025Article
- Comparison of the long-term prognostic value of different frailty instruments in older inpatients: a 5-year prospective cohort study.European journal of medical research · 2025Article
- The Relationship of Frailty with Surgical and Laser Treatment for Patients with Glaucoma.Clinical ophthalmology (Auckland, N.Z.) · 2025Article
- Improving Surgical Outcomes for Older Adults with Adoption of Technological Advances in Comprehensive Geriatric Assessment.Seminars in colon & rectal surgery · 2024Article
- Development and validation of an electronic frailty index in a national health maintenance organization.Aging · 2024Article
- Cross-sectional and longitudinal associations among healthcare costs and deficit accumulation.Journal of the American Geriatrics Society · 2024Article
- What is the additive value of nutritional deficiency to VA-FI in the risk assessment for heart failure patients?The journal of nutrition, health & aging · 2024Article
- TAVR in Older Adults: Moving Toward a Comprehensive Geriatric Assessment and Away From Chronological Age:JACC. Advances · 2024Article
- The Association of Frailty and Neighborhood Disadvantage with Emergency Department Visits and Hospitalizations in Older Adults.Journal of general internal medicine · 2024Observational
- Association of CT-Derived Skeletal Muscle and Adipose Tissue Metrics with Frailty in Older Adults.Academic radiology · 2024Article
- Development and Validation of an Intracranial Hemorrhage Risk Score in Older Adults with Atrial Fibrillation Treated with Oral Anticoagulant.Clinical epidemiology · 2024Article
- Strategies to Assess and Manage Frailty among Patients Diagnosed with Primary Malignant Brain Tumors.Current treatment options in oncology · 2024Review
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
backgroundFrailty is associated with numerous post-operative adverse outcomes in older adults. Current pre-operative frailty screening tools require additional data collection or objective assessments, adding expense and limiting large-scale implementation.
objectiveTo evaluate the association of an automated measure of frailty integrated within the Electronic Health Record (EHR) with post-operative outcomes for nonemergency surgeries.
designRetrospective cohort study.
settingAcademic Medical Center.
participantsPatients 65 years or older that underwent nonemergency surgery with an inpatient stay 24 hours or more between October 8th, 2017 and June 1st, 2019. EXPOSURES: Frailty as measured by a 54-item electronic frailty index (eFI). OUTCOMES AND MEASUREMENTS: Inpatient length of stay, requirements for post-acute care, 30-day readmission, and 6-month all-cause mortality.
resultsOf 4,831 unique patients (2,281 females (47.3%); mean (SD) age, 73.2 (5.9) years), 4,143 (85.7%) had sufficient EHR data to calculate the eFI, with 15.1% categorized as frail (eFI > 0.21) and 50.9% pre-frail (0.10 < eFI ≤ 0.21). For all outcomes, there was a generally a gradation of risk with higher eFI scores. For example, adjusting for age, sex, race/ethnicity, and American Society of Anesthesiologists class, and accounting for variability by service line, patients identified as frail based on the eFI, compared to fit patients, had greater needs for post-acute care (odds ratio (OR) = 1.68; 95% confidence interval (CI) = 1.36-2.08), higher rates of 30-day readmission (hazard ratio (HR) = 2.46; 95%CI = 1.72-3.52) and higher all-cause mortality (HR = 2.86; 95%CI = 1.84-4.44) over 6 months' follow-up.
conclusionsThe eFI, an automated digital marker for frailty integrated within the EHR, can facilitate pre-operative frailty screening at scale.
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Registered trials
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