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Older people are increasing users of health care globally. Constraints in bed capacity and resources raise important challenges with regards to management of older people with complex needs, which usually require assertive and holistic assessment. It is important, therefore, to identify aged patients most likely to benefit from such frailty-attuned approaches of care. A previous study using national Hospital Episodes Statistics conducted in the United Kingdom (UK) showed that patients aged over 75 years with characteristics of frailty and at risk of adverse health-care outcomes can be identified using routinely collected data (Gilbert T et al., Lancet 2018). This study lead to the development of the Hospital Frailty Risk Score (HFRS), which is based on International Statistical Classification of Diseases and Related Health Problems 10 (ICD-10) diagnosis codes and has the potential to be used in other countries worldwide, using the ICD-10 coding framework, to identify patients at risk of frailty at the hospital and commissioners levels, as well as for database research purposes. This score has successfully been validated in Canada, Australia and Switzerland. The aim of the present study is to evaluate the ability of the HFRS to predict 30-day in-patient mortality of patients aged 75 years and older admitted to French hospitals as an emergency.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients aged 75 years and older hospitalized as an emergency | Patients considered will be all patients aged 75 years and older (on the day of the index admission) hospitalized as an emergency (i.e. after visit to ED) between january 2017 and december 2017. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| None (retrospective observational study) | Other | This multi-centric retrospective observational cohort study is conducted using the PMSI. Predictive ability of HFRS estimated on the basis of 3 binary outcomes: 30-day in-patient mortality (main outcome), 30-day emergency and potentially avoidable readmission, length of stay >15 days. Odds ratios (ORs) and c-statistics calculated and compared to the original UK results in order to validate the use of the HFRS in France. Other secondary objectives include:
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| Measure | Description | Time Frame |
|---|---|---|
| 30-day in-patient mortality | The main outcome measure will be 30-day in-patient mortality. Mortality data will be limited to in-hospital mortality, which will be directly available from the PMSI database. | In-patient mortality within 30 days from admission (index hospitalization) |
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Inclusion Criteria:
Exclusion Criteria:
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Patients considered will be all patients aged 75 years and older hospitalized as an emergency over a one year period ranging from January to December 2017.
According to a preliminary extraction, we expect to include approximately one million patients.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| service de court séjour gériatrique, Hôpital Lyon Sud | Pierre-Bénite | 69495 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 38079225 | Derived | Gilbert T, Cordier Q, Polazzi S, Street A, Conroy S, Duclos A. Combining the Hospital Frailty Risk Score With the Charlson and Elixhauser Multimorbidity Indices to Identify Older Patients at Risk of Poor Outcomes in Acute Care. Med Care. 2024 Feb 1;62(2):117-124. doi: 10.1097/MLR.0000000000001962. Epub 2023 Dec 11. | |
| 34185827 | Derived |
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| ID | Term |
|---|---|
| D000073496 | Frailty |
| ID | Term |
|---|---|
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| Gilbert T, Cordier Q, Polazzi S, Bonnefoy M, Keeble E, Street A, Conroy S, Duclos A. External validation of the Hospital Frailty Risk Score in France. Age Ageing. 2022 Jan 6;51(1):afab126. doi: 10.1093/ageing/afab126. |