Prevalence of frailty in a tertiary hospital: A point prevalence observational study

by Simon J. G. Richards, Joel D’Souza, Rebecca Pascoe, Michelle Falloon, Frank A. Frizelle

Introduction

Frailty is an important concept in modern healthcare due to its association with adverse outcomes. Its prevalence varies in the literature and there is a paucity of literature looking at the prevalence of frailty in an inpatient setting. Its significance lies on its impact on resource utilisation and costs.

Aim

To determine the prevalence of frailty in the adult population in a tertiary New Zealand hospital.

Methods

Eligible patients aged 18 years and over were invited to participate, and frailty assessment was performed using the Reported Edmonton Frail Scale. A score of 8 or more was considered frail. Factors associated with frailty were assessed.

Results

Of 640 occupied inpatient beds, 420 patients were assessed. 220 patients were excluded, of which 89 were absent from their bed-space, 73 declined and 41 were critically unwell. The overall prevalence of frailty across assessed patients was 48.8%. The prevalence of frailty increased significantly with age; patients aged 85 and over were significantly more likely to be frail compared to those aged under 65 (OR 6.25, 95% CI 3.17–12.7). Maori patients were significantly more likely to be frail (OR 4.0, 95% CI 1.45–11.9). When compared to those patients admitted to a medical specialty, patients admitted to surgical specialty were less likely to be frail (OR 0.52 95% CI 0.31–0.86) and those admitted for rehabilitation were more likely to be frail (OR 1.86 95% CI 1.03–3.41). Frail patients were more likely to come from a rest home (OR 2.81, 95% CI 1.38–6.14) or hospital level care (OR 9.62, 95% CI 2.68–61.6).

Conclusion

Frailty is highly prevalent in the hospital setting with 48.8% of all inpatients classified as frail. This high number of frail patients has significant resource implications and an increased understanding of the burden of frailty in this population may aid targeting of interventions towards this vulnerable population.