Self-assessed frailty may predict use of healthcare services
Frailty level may predict an individual's risk of developing severe health issues, according to a new Danish study.
A new study has examined whether the degree of frailty in adults with multiple chronic conditions can predict their risk of three adverse health outcomes: repeated healthcare contacts, hospital admissions and mortality.
The study is based on data from hospitals, general practice and municipal healthcare services. One of the authors is Anders Prior, senior researcher at the Research Unit for General Practice in Aarhus.
Elevated risk of hospital readmission and death
Frailty was assessed using the Tilburg Frailty Indicator (TFI) questionnaire, which comprises 15 items covering physical, psychological and social aspects.
The results show that individuals who rated themselves as frail (TFI score above 5) had a markedly higher risk of dying within 180 days compared to non-frail individuals.
Frail individuals also had an elevated risk of being readmitted to a hospital within 30 days and having more healthcare contacts. In addition, the analyses indicated that the risk increased progressively with each additional point on the TFI scale.
Simple tool for assessing risk
The TFI questionnaire can be used to identify patients at increased risk of serious health outcomes. As the TFI is based on self-reporting, the assessment does not require clinical measurements or specialist evaluation. Therefore, it can serve as a simple and practical instrument in the planning of treatment and follow-up for patients with multiple concurrent chronic conditions.
According to Anders Prior, the study suggests that the TFI score can provide an overall assessment of a person's risk of readmission within 30 days and of death within six months. In addition, the score can also be used to predict the person's expected utilisation of future healthcare services.
“Frailty exists on a continuum; it is not simply a matter of having it or not having it. The higher the score, the greater the risk of developing health problems – and as a physician, one should pay particular attention to patients with a high score,” explains Anders Prior.
The association between TFI score and the risk of developing severe health issues was observed across age groups, including younger adults with multiple chronic conditions. However, some of the analyses suggest that these associations may vary with age, which should be investigated in future studies.
Read the article ”Association of the Tilburg Frailty Indicator with mortality, readmission, and healthcare contacts in adult patients with multimorbidity” in Journal of Multimorbidity and Comorbidity.
Further information
Senior researcher, general practitioner Anders Prior
Research Unit for General Practice, Aarhus
E-mail: anders.prior@ph.au.dk
About the study
- The cohort comprises 471 adults (median age: 70 years) with at least two chronic conditions.
- Participants were recruited from hospitals, general practice and community-based home care in the Central Denmark Region.
- Participants were followed for 180 days to map patterns in healthcare contacts, readmissions and mortality.
- The study was approved by the Danish Data Protection Agency and conducted in accordance with the ethical principles of the Declaration of Helsinki and guidelines for clinical research.
- The study was supported by the Clinical Academic Group for Multimorbidity, Regional Hospital Central Jutland and the Health Research Foundation of the Central Denmark Region.