Evidence map›Paper›PMID 36735847›Full record

ArticleAge and ageing2023

External validation of the hospital frailty risk score among hospitalised home care clients in Canada: a retrospective cohort study.

Luke Andrew Turcotte, George Heckman, Kenneth Rockwood, Davide Liborio Vetrano, Paul Hébert, Daniel I McIsaac, Elizabeth Rhynold, Lori Mitchell, Fabrice Immanuel Mowbray, Rasmus T Larsen and 1 more

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In one paragraph

Article in Age and ageing, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  5. Observational
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  8. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Luke Andrew TurcotteSchool of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.ORCID 0000-0001-5678-7234
George HeckmanSchool of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.
Kenneth RockwoodDepartment of Medicine, Dalhousie University and Nova Scotia Health, Halifax, Nova Scotia, Canada.
Davide Liborio VetranoAging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institute and Stockholm University, Stockholm, Sweden, & Stockholm Gerontology Research Center, Stockholm, Sweden.
Paul HébertUniversité de Montréal et Centre Hospitalier de l'Université de Montréal, Montréal, Canada.
Daniel I McIsaacDepartments of Anesthesiology & Pain Medicine, University of Ottawa, and The Ottawa Hospital; School of Epidemiology & Public Health, University of Ottawa, Ottawa, Ontario, Canada.ORCID 0000-0002-8543-1859
Elizabeth RhynoldSection of Geriatric Medicine, University of Manitoba and Prairie Mountain Health, Manitoba, Canada.
Lori MitchellHome Care Program, Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada.
Fabrice Immanuel MowbrayDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Rasmus T LarsenDepartment of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital, Copenhagen, Denmark.
John P HirdesSchool of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe 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).

objectiveMeasure the correlation between the HFRS, CFS and FI and compare prognostic utility for frailty-related outcomes.

designRetrospective cohort study.

settingAlberta, 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).

methodsCorrelation 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).

resultsThe 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).

conclusionsThe 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.

Indexed as

FrailtyHome Care ServicesAgedFrail ElderlyGeriatric AssessmentHospitalsHumansOntarioRetrospective StudiesRisk Factorsfrailtyhospitalisationolder adultsolder peoplerisk assessment

Identifiers

PMID36735847
PMCPMC9897298

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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.