ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2023
Development and validation of a hospital frailty risk measure using Canadian clinical administrative data.
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Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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12citing papers in PubMed
3.6field-weighted citation impact, top 7% of its field
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Who cites it
12 citing papers in PubMed, 20 citations in OpenAlex.
- Development of a population-level frfailty index using Quebec administrative data: a Canadian retrospective study.BMJ open · 2026Observational
- Emergency trauma admissions in the oldest-old: short- and long-term mortality and the role of frailty in a Turkish national cohort of centenarians.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Comparison of two electronic medical record-based frailty assessment tools and their association with adverse outcomes in older hospitalized patients with urgent admissions.International journal of emergency medicine · 2025Article
- Comparing outcomes of ureteric stent versus nephrostomy tube in urosepsis: a population-based study in Ontario, Canada.World journal of urology · 2025Article
- Greenness and hospital admissions for cause specific mental disorders: multicountry time series study.BMJ (Clinical research ed.) · 2025Article
- Nontuberculous Mycobacterial Disease in Solid-Organ Transplant Recipients and the General Population.JAMA network open · 2025Article
- Hospitalization risk and burden for cause-specific cardiovascular diseases following tropical cyclones: A multicountry study.Science advances · 2025Article
- Timing of sodium-glucose cotransporter 2 inhibitor initiation and post-discharge outcomes in acute heart failure with diabetes: A population-based cohort study.European journal of heart failure · 2025Article
- Patient Complexity, Social Factors, and Hospitalization Outcomes at Academic and Community Hospitals.JAMA network open · 2025Article
- Modified Hospital Frailty Risk Score (mHFRS) as a Tool to Identify and Predict Outcomes for Hospitalised Older Adults at Risk of Frailty.Journal of frailty, sarcopenia and falls · 2024Article
- Cross-sectional and longitudinal associations among healthcare costs and deficit accumulation.Journal of the American Geriatrics Society · 2024Article
- Identifying Predictors of Nursing Home Admission by Using Electronic Health Records and Administrative Data: Scoping Review.JMIR aging · 2023Article
Corrections and comments
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Authors and funding
13 authors at 1 institution in 1 country.
Joseph Emmanuel AmuahCanadian Institute for Health Information (Amuah, Molodianovitsh, Carbone, Diestelkamp, Guo, Li, Karmakar-Hore); School of Epidemiology and Public Health (Amuah), University of Ottawa, Ottawa, Ont.; Institute of Health Policy, Management and Evaluation (Carbone), University of Toronto, Toronto, Ont.; School of Public Health Sciences (Guo, Maxwell), University of Waterloo, Waterloo, Ont.; Division of Geriatric Medicine (Hogan), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; School of Pharmacy (Maxwell), University of Waterloo, Waterloo, Ont.; Department of Critical Care Medicine (Muscedere), Queen's University; Canadian Frailty Network (Muscedere), Kingston, Ont.; Division of Geriatric Medicine, Department of Medicine (Rockwood), Dalhousie University, Halifax, NS; Division of Geriatric Medicine (Sinha), Department of Medicine, University of Toronto; National Institute on Ageing (Sinha), Ryerson University, Toronto, Ont.; School of Physiotherapy and Division of Geriatric Medicine (Theou), Dalhousie University, Halifax, NS.
Katy MolodianovitshCanadian Institute for Health Information (Amuah, Molodianovitsh, Carbone, Diestelkamp, Guo, Li, Karmakar-Hore); School of Epidemiology and Public Health (Amuah), University of Ottawa, Ottawa, Ont.; Institute of Health Policy, Management and Evaluation (Carbone), University of Toronto, Toronto, Ont.; School of Public Health Sciences (Guo, Maxwell), University of Waterloo, Waterloo, Ont.; Division of Geriatric Medicine (Hogan), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; School of Pharmacy (Maxwell), University of Waterloo, Waterloo, Ont.; Department of Critical Care Medicine (Muscedere), Queen's University; Canadian Frailty Network (Muscedere), Kingston, Ont.; Division of Geriatric Medicine, Department of Medicine (Rockwood), Dalhousie University, Halifax, NS; Division of Geriatric Medicine (Sinha), Department of Medicine, University of Toronto; National Institute on Ageing (Sinha), Ryerson University, Toronto, Ont.; School of Physiotherapy and Division of Geriatric Medicine (Theou), Dalhousie University, Halifax, NS.
Sarah CarboneCanadian Institute for Health Information (Amuah, Molodianovitsh, Carbone, Diestelkamp, Guo, Li, Karmakar-Hore); School of Epidemiology and Public Health (Amuah), University of Ottawa, Ottawa, Ont.; Institute of Health Policy, Management and Evaluation (Carbone), University of Toronto, Toronto, Ont.; School of Public Health Sciences (Guo, Maxwell), University of Waterloo, Waterloo, Ont.; Division of Geriatric Medicine (Hogan), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; School of Pharmacy (Maxwell), University of Waterloo, Waterloo, Ont.; Department of Critical Care Medicine (Muscedere), Queen's University; Canadian Frailty Network (Muscedere), Kingston, Ont.; Division of Geriatric Medicine, Department of Medicine (Rockwood), Dalhousie University, Halifax, NS; Division of Geriatric Medicine (Sinha), Department of Medicine, University of Toronto; National Institute on Ageing (Sinha), Ryerson University, Toronto, Ont.; School of Physiotherapy and Division of Geriatric Medicine (Theou), Dalhousie University, Halifax, NS.
Naomi DiestelkampCanadian Institute for Health Information (Amuah, Molodianovitsh, Carbone, Diestelkamp, Guo, Li, Karmakar-Hore); School of Epidemiology and Public Health (Amuah), University of Ottawa, Ottawa, Ont.; Institute of Health Policy, Management and Evaluation (Carbone), University of Toronto, Toronto, Ont.; School of Public Health Sciences (Guo, Maxwell), University of Waterloo, Waterloo, Ont.; Division of Geriatric Medicine (Hogan), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; School of Pharmacy (Maxwell), University of Waterloo, Waterloo, Ont.; Department of Critical Care Medicine (Muscedere), Queen's University; Canadian Frailty Network (Muscedere), Kingston, Ont.; Division of Geriatric Medicine, Department of Medicine (Rockwood), Dalhousie University, Halifax, NS; Division of Geriatric Medicine (Sinha), Department of Medicine, University of Toronto; National Institute on Ageing (Sinha), Ryerson University, Toronto, Ont.; School of Physiotherapy and Division of Geriatric Medicine (Theou), Dalhousie University, Halifax, NS.
Yanling GuoCanadian Institute for Health Information (Amuah, Molodianovitsh, Carbone, Diestelkamp, Guo, Li, Karmakar-Hore); School of Epidemiology and Public Health (Amuah), University of Ottawa, Ottawa, Ont.; Institute of Health Policy, Management and Evaluation (Carbone), University of Toronto, Toronto, Ont.; School of Public Health Sciences (Guo, Maxwell), University of Waterloo, Waterloo, Ont.; Division of Geriatric Medicine (Hogan), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; School of Pharmacy (Maxwell), University of Waterloo, Waterloo, Ont.; Department of Critical Care Medicine (Muscedere), Queen's University; Canadian Frailty Network (Muscedere), Kingston, Ont.; Division of Geriatric Medicine, Department of Medicine (Rockwood), Dalhousie University, Halifax, NS; Division of Geriatric Medicine (Sinha), Department of Medicine, University of Toronto; National Institute on Ageing (Sinha), Ryerson University, Toronto, Ont.; School of Physiotherapy and Division of Geriatric Medicine (Theou), Dalhousie University, Halifax, NS.
David B HoganCanadian Institute for Health Information (Amuah, Molodianovitsh, Carbone, Diestelkamp, Guo, Li, Karmakar-Hore); School of Epidemiology and Public Health (Amuah), University of Ottawa, Ottawa, Ont.; Institute of Health Policy, Management and Evaluation (Carbone), University of Toronto, Toronto, Ont.; School of Public Health Sciences (Guo, Maxwell), University of Waterloo, Waterloo, Ont.; Division of Geriatric Medicine (Hogan), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; School of Pharmacy (Maxwell), University of Waterloo, Waterloo, Ont.; Department of Critical Care Medicine (Muscedere), Queen's University; Canadian Frailty Network (Muscedere), Kingston, Ont.; Division of Geriatric Medicine, Department of Medicine (Rockwood), Dalhousie University, Halifax, NS; Division of Geriatric Medicine (Sinha), Department of Medicine, University of Toronto; National Institute on Ageing (Sinha), Ryerson University, Toronto, Ont.; School of Physiotherapy and Division of Geriatric Medicine (Theou), Dalhousie University, Halifax, NS.
Mingyang LiCanadian Institute for Health Information (Amuah, Molodianovitsh, Carbone, Diestelkamp, Guo, Li, Karmakar-Hore); School of Epidemiology and Public Health (Amuah), University of Ottawa, Ottawa, Ont.; Institute of Health Policy, Management and Evaluation (Carbone), University of Toronto, Toronto, Ont.; School of Public Health Sciences (Guo, Maxwell), University of Waterloo, Waterloo, Ont.; Division of Geriatric Medicine (Hogan), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; School of Pharmacy (Maxwell), University of Waterloo, Waterloo, Ont.; Department of Critical Care Medicine (Muscedere), Queen's University; Canadian Frailty Network (Muscedere), Kingston, Ont.; Division of Geriatric Medicine, Department of Medicine (Rockwood), Dalhousie University, Halifax, NS; Division of Geriatric Medicine (Sinha), Department of Medicine, University of Toronto; National Institute on Ageing (Sinha), Ryerson University, Toronto, Ont.; School of Physiotherapy and Division of Geriatric Medicine (Theou), Dalhousie University, Halifax, NS.
Colleen J MaxwellCanadian Institute for Health Information (Amuah, Molodianovitsh, Carbone, Diestelkamp, Guo, Li, Karmakar-Hore); School of Epidemiology and Public Health (Amuah), University of Ottawa, Ottawa, Ont.; Institute of Health Policy, Management and Evaluation (Carbone), University of Toronto, Toronto, Ont.; School of Public Health Sciences (Guo, Maxwell), University of Waterloo, Waterloo, Ont.; Division of Geriatric Medicine (Hogan), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; School of Pharmacy (Maxwell), University of Waterloo, Waterloo, Ont.; Department of Critical Care Medicine (Muscedere), Queen's University; Canadian Frailty Network (Muscedere), Kingston, Ont.; Division of Geriatric Medicine, Department of Medicine (Rockwood), Dalhousie University, Halifax, NS; Division of Geriatric Medicine (Sinha), Department of Medicine, University of Toronto; National Institute on Ageing (Sinha), Ryerson University, Toronto, Ont.; School of Physiotherapy and Division of Geriatric Medicine (Theou), Dalhousie University, Halifax, NS.
John MuscedereCanadian Institute for Health Information (Amuah, Molodianovitsh, Carbone, Diestelkamp, Guo, Li, Karmakar-Hore); School of Epidemiology and Public Health (Amuah), University of Ottawa, Ottawa, Ont.; Institute of Health Policy, Management and Evaluation (Carbone), University of Toronto, Toronto, Ont.; School of Public Health Sciences (Guo, Maxwell), University of Waterloo, Waterloo, Ont.; Division of Geriatric Medicine (Hogan), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; School of Pharmacy (Maxwell), University of Waterloo, Waterloo, Ont.; Department of Critical Care Medicine (Muscedere), Queen's University; Canadian Frailty Network (Muscedere), Kingston, Ont.; Division of Geriatric Medicine, Department of Medicine (Rockwood), Dalhousie University, Halifax, NS; Division of Geriatric Medicine (Sinha), Department of Medicine, University of Toronto; National Institute on Ageing (Sinha), Ryerson University, Toronto, Ont.; School of Physiotherapy and Division of Geriatric Medicine (Theou), Dalhousie University, Halifax, NS.
Kenneth RockwoodCanadian Institute for Health Information (Amuah, Molodianovitsh, Carbone, Diestelkamp, Guo, Li, Karmakar-Hore); School of Epidemiology and Public Health (Amuah), University of Ottawa, Ottawa, Ont.; Institute of Health Policy, Management and Evaluation (Carbone), University of Toronto, Toronto, Ont.; School of Public Health Sciences (Guo, Maxwell), University of Waterloo, Waterloo, Ont.; Division of Geriatric Medicine (Hogan), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; School of Pharmacy (Maxwell), University of Waterloo, Waterloo, Ont.; Department of Critical Care Medicine (Muscedere), Queen's University; Canadian Frailty Network (Muscedere), Kingston, Ont.; Division of Geriatric Medicine, Department of Medicine (Rockwood), Dalhousie University, Halifax, NS; Division of Geriatric Medicine (Sinha), Department of Medicine, University of Toronto; National Institute on Ageing (Sinha), Ryerson University, Toronto, Ont.; School of Physiotherapy and Division of Geriatric Medicine (Theou), Dalhousie University, Halifax, NS.
Samir SinhaCanadian Institute for Health Information (Amuah, Molodianovitsh, Carbone, Diestelkamp, Guo, Li, Karmakar-Hore); School of Epidemiology and Public Health (Amuah), University of Ottawa, Ottawa, Ont.; Institute of Health Policy, Management and Evaluation (Carbone), University of Toronto, Toronto, Ont.; School of Public Health Sciences (Guo, Maxwell), University of Waterloo, Waterloo, Ont.; Division of Geriatric Medicine (Hogan), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; School of Pharmacy (Maxwell), University of Waterloo, Waterloo, Ont.; Department of Critical Care Medicine (Muscedere), Queen's University; Canadian Frailty Network (Muscedere), Kingston, Ont.; Division of Geriatric Medicine, Department of Medicine (Rockwood), Dalhousie University, Halifax, NS; Division of Geriatric Medicine (Sinha), Department of Medicine, University of Toronto; National Institute on Ageing (Sinha), Ryerson University, Toronto, Ont.; School of Physiotherapy and Division of Geriatric Medicine (Theou), Dalhousie University, Halifax, NS.
Olga TheouCanadian Institute for Health Information (Amuah, Molodianovitsh, Carbone, Diestelkamp, Guo, Li, Karmakar-Hore); School of Epidemiology and Public Health (Amuah), University of Ottawa, Ottawa, Ont.; Institute of Health Policy, Management and Evaluation (Carbone), University of Toronto, Toronto, Ont.; School of Public Health Sciences (Guo, Maxwell), University of Waterloo, Waterloo, Ont.; Division of Geriatric Medicine (Hogan), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; School of Pharmacy (Maxwell), University of Waterloo, Waterloo, Ont.; Department of Critical Care Medicine (Muscedere), Queen's University; Canadian Frailty Network (Muscedere), Kingston, Ont.; Division of Geriatric Medicine, Department of Medicine (Rockwood), Dalhousie University, Halifax, NS; Division of Geriatric Medicine (Sinha), Department of Medicine, University of Toronto; National Institute on Ageing (Sinha), Ryerson University, Toronto, Ont.; School of Physiotherapy and Division of Geriatric Medicine (Theou), Dalhousie University, Halifax, NS.
Sunita Karmakar-HoreCanadian Institute for Health Information (Amuah, Molodianovitsh, Carbone, Diestelkamp, Guo, Li, Karmakar-Hore); School of Epidemiology and Public Health (Amuah), University of Ottawa, Ottawa, Ont.; Institute of Health Policy, Management and Evaluation (Carbone), University of Toronto, Toronto, Ont.; School of Public Health Sciences (Guo, Maxwell), University of Waterloo, Waterloo, Ont.; Division of Geriatric Medicine (Hogan), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; School of Pharmacy (Maxwell), University of Waterloo, Waterloo, Ont.; Department of Critical Care Medicine (Muscedere), Queen's University; Canadian Frailty Network (Muscedere), Kingston, Ont.; Division of Geriatric Medicine, Department of Medicine (Rockwood), Dalhousie University, Halifax, NS; Division of Geriatric Medicine (Sinha), Department of Medicine, University of Toronto; National Institute on Ageing (Sinha), Ryerson University, Toronto, Ont.; School of Physiotherapy and Division of Geriatric Medicine (Theou), Dalhousie University, Halifax, NS SKarmakar-Hore@cihi.ca.
University of Waterloo · CA
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAccessible measures specific to the Canadian context are needed to support health system planning for older adults living with frailty. We sought to develop and validate the Canadian Institute for Health Information (CIHI) Hospital Frailty Risk Measure (HFRM).
methodsUsing CIHI administrative data, we conducted a retrospective cohort study involving patients aged 65 years and older who were discharged from Canadian hospitals from Apr. 1, 2018, to Mar. 31, 2019. We used a 2-phase approach to develop and validate the CIHI HFRM. The first phase, construction of the measure, was based on the deficit accumulation approach (identification of age-related conditions using a 2-year look-back). The second phase involved refinement into 3 formats (continuous risk score, 8 risk groups and binary risk measure), with assessment of their predictive validity for several frailty-related adverse outcomes using data to 2019/20. We assessed convergent validity with the United Kingdom Hospital Frailty Risk Score.
resultsThe cohort consisted of 788 701 patients. The CIHI HFRM included 36 deficit categories and 595 diagnosis codes that cover morbidity, function, sensory loss, cognition and mood. The median continuous risk score was 0.111 (interquartile range 0.056-0.194, equivalent to 2-7 deficits); 35.1% (
interpretationThe CIHI HFRM is a valid tool showing good discriminatory power for several adverse outcomes. The tool can be used by decision-makers and researchers by providing information on hospital-level prevalence of frailty to support system-level capacity planning for Canada's aging population.
Indexed as
FrailtyAgedCanadaFrail ElderlyGeriatric AssessmentHospitalizationHospitalsHumansRetrospective StudiesRisk Factors
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