ArticleThe Lancet regional health. Europe2021
Association of entirely claims-based frailty indices with long-term outcomes in patients with acute myocardial infarction, heart failure, or pneumonia: a nationwide cohort study in Turkey.
Article in The Lancet regional health. Europe, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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17 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Impact of frailty on pneumonia outcomes in older patients: a systematic review and meta-analysis.European geriatric medicine · 2024Pooled it
- Comparison of Electronic Health Data-Based Frailty Assessment Tools for Prediction of Adverse Outcomes of Patients With Chronic Kidney Disease.Nephrology (Carlton, Vic.) · 2026Article
- Comparative effectiveness and safety of fluticasone-based versus beclometasone-based single-inhaler triple therapies in patients with chronic obstructive pulmonary disease: a population-based cohort study.International journal of clinical pharmacy · 2026Article
- Frailty scale with the best prediction of mortality in individuals diagnosed with acute coronary syndrome: systematic review and meta-analysis.Journal of geriatric cardiology : JGC · 2026Article
- Cardiovascular Risks of Aromatase Inhibitors versus Tamoxifen in Postmenopausal Breast Cancer: A Multinational Cohort Study.Clinical epidemiology · 2026Article
- The effects of invasive treatment on patients with frailty and non-ST-segment elevation myocardial infarction.Scientific reports · 2025Article
- Continuation Versus Discontinuation of Sodium-Glucose Cotransporter-2 Inhibitors and Cardiorenal Outcomes Among Patients With Type 2 Diabetes and Chronic Kidney Disease: A Nationwide Cohort Study With a Target Trial Emulation Framework.Clinical and translational science · 2025Article
- CORR Synthesis: What Is the Impact of Frailty on Postoperative Complications After Spinal Surgery?Clinical orthopaedics and related research · 2025Article
- Risk of Atherosclerotic Cardiovascular Disease After Chronic Obstructive Pulmonary Disease Hospitalization among Primary and Secondary Prevention Older Adults.Journal of the American Heart Association · 2025Article
- Comparison of Transcatheter Versus Surgical Tricuspid Repair Among Patients With Tricuspid Regurgitation: Two-Year Results.Circulation. Cardiovascular interventions · 2025Article
- Identifying core adverse health outcomes for frailty assessment in older adults using administrative data.Frontiers in medicine · 2025Article
- Risk of Atherosclerotic Cardiovascular Disease Hospitalizations after Chronic Obstructive Pulmonary Disease Hospitalization among Older Adults.Annals of the American Thoracic Society · 2024Article
- Risk of Atherosclerotic Cardiovascular Disease Hospitalizations after COPD Hospitalization among Older Adults.medRxiv : the preprint server for health sciences · 2023Article
- Frailty, Treatments, and Outcomes in Older Patients With Myocardial Infarction: A Nationwide Registry-Based Study.Journal of the American Heart Association · 2023Article
- Derivation and validation of an epigenetic frailty risk score in population-based cohorts of older adults.Nature communications · 2022Article
- Association between frailty and short- and long-term mortality in patients with critical acute myocardial infarction: Results from MIMIC-IV.Frontiers in cardiovascular medicine · 2022Article
- Claims-based Frailty indices may function as long-term risk estimates for elderly patients after hospitalization.The Lancet regional health. Europe · 2021Article
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Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSeveral countries have increasingly focused on improving care for acute myocardial infarction (AMI), heart failure (HF), and pneumonia to reduce their readmissions and mortality rates. Frailty is becoming increasingly important to accurately predict healthcare utilization for the aging population. The preferred method for the measurement of frailty remains unclear, and current risk-adjustment models do not account for frailty. We sought to compare commonly used frailty indices in terms of the ability to predict clinical adverse outcomes in AMI, HF, and pneumonia patients.
methodsA nationwide cohort study included AMI, HF, and pneumonia with 65 years and older patients in the Turkey between January 1 and December 31, 2018. The primary predictor of interest was frailty. We used two claims-based frailty indices (Johns Hopkins Claims-Based Frailty Index and Hospital Frailty Risk Score) to assess frailty. The main outcome was all-cause long-term mortality up to 3 years. Time to death was calculated as the time period between the date of first admission and the date of death. Patients were censored as of September 30, 2020, which marked the end of the follow-up period.
findingsOf the 200,948 patients, 35,096 (17.5%) had AMI, 62,403 (31.1%) had HF, and 103,449 (51.5%) had pneumonia. Johns Hopkins Claims-Based Frailty Index (c-statistics for long-term mortality: 0.68 in AMI, 0.61 in HF, 0.64 in pneumonia) was better compared to Hospital Frailty Risk Score (c-statistics for long-term mortality: AMI=0.62, HF=0.58, pneumonia=0.62) (DeLong p<0.001 in all).
interpretationReadmission and mortality rates after AMI, HF, and pneumonia gradually increases with increasing frailty score. While the Hospital Frailty Risk Score had a better discrimination for predicting readmissions, Johns Hopkins Claims-Based Frailty Index had a better discrimination for predicting mortality. These findings should be taken into account for a better evaluation of hospital performance.
fundingThis study was supported by funding from The Scientific and Technological Research Council of Turkey (grant 120S422, HK).
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