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Frailty assessment, hip fracture and long‐term clinical outcomes in older adults

2020; Wiley; Volume: 51; Issue: 4 Linguagem: Inglês

10.1111/eci.13445

1365-2362

Monica Pizzonia, Chiara Giannotti, Luca Carmisciano, Alessio Signori, Gianmarco Rosa, Federico Santolini, Irene Caffa, Fabrizio Montecucco, Alessio Nencioni, Fiammetta Monacelli,

Nutrition and Health in Aging

The primary aim of the study was determining the validation of the modified 19-item Frailty Index (mFI-19), based on the standard procedure for creating a frailty index scoring in the accumulation deficit theory of Rockwood and comparing it with the gold standard comprehensive geriatric assessment (CGA) in old age patients with hip fracture. As a secondary aim, we compared prognostic accuracies of mFI-19 and CGA in predicting long-term mortality after surgery.A total of 364 older patients with hip fractures, each a candidate for surgery, were consecutively enrolled. All were subjected to CGA and mFI-19 at baseline and time to death (years from hip surgery) were collected prospectively.Mean patient age was 86.5 (SD: 5.65) years. The most common clinical phenotype (77%) was frail. Both CGA and mFI-19 performed similarly in predicting long-term mortality (Harrell's C-index: 0.66 and 0.68, respectively).The mFI-19 was validated, compared to the gold standard CGA, based on a systematic process for creating a frailty index in relation to the accumulation deficit. This is one of few prospective studies addressing long-term mortality in older adults with hip fractures, invoking a methodologically robust frailty screening assessment.