FI-Lab predicts all-cause mortality, but not successful rehabilitation, among patients aged 65 and older after hip or pelvic fracture

PurposeOver the past decade, the Frailty Index based on Laboratory data (FI-Lab index) has been effective in predicting complications during hospitalization, length of hospital stay, changes in functional status, and even mortality. The aims of the present study were to examine the associations betw...

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Main Authors: Evgeniya Zikrin, Abdu El Karim Hilali, David Shacham, Reut Frenkel, Olga Abel, Muhammad Abo Abed, Ahmed Abu-Ajaj, Natalia Velikiy, Tamar Freud, Yan Press
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1627026/full
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author Evgeniya Zikrin
Evgeniya Zikrin
Abdu El Karim Hilali
Abdu El Karim Hilali
David Shacham
David Shacham
Reut Frenkel
Reut Frenkel
Olga Abel
Olga Abel
Muhammad Abo Abed
Muhammad Abo Abed
Ahmed Abu-Ajaj
Ahmed Abu-Ajaj
Natalia Velikiy
Natalia Velikiy
Tamar Freud
Tamar Freud
Tamar Freud
Yan Press
Yan Press
Yan Press
Yan Press
Yan Press
Yan Press
author_facet Evgeniya Zikrin
Evgeniya Zikrin
Abdu El Karim Hilali
Abdu El Karim Hilali
David Shacham
David Shacham
Reut Frenkel
Reut Frenkel
Olga Abel
Olga Abel
Muhammad Abo Abed
Muhammad Abo Abed
Ahmed Abu-Ajaj
Ahmed Abu-Ajaj
Natalia Velikiy
Natalia Velikiy
Tamar Freud
Tamar Freud
Tamar Freud
Yan Press
Yan Press
Yan Press
Yan Press
Yan Press
Yan Press
author_sort Evgeniya Zikrin
collection DOAJ
description PurposeOver the past decade, the Frailty Index based on Laboratory data (FI-Lab index) has been effective in predicting complications during hospitalization, length of hospital stay, changes in functional status, and even mortality. The aims of the present study were to examine the associations between FI-Lab, rehabilitation outcomes, and mortality following hip and pelvic fractures.MethodsA retrospective study of patients 65 years of age and above who underwent rehabilitation after hip or pelvic fracture in the Geriatric Department, between January 2018 and December 2024. Data included demographic variables, comorbidity, and all-cause mortality. The FI-Lab was calculated based on 26 available blood tests, as well as blood pressure and heart rate measurements. Rehabilitation outcomes were measured using the Montebello Rehabilitation Factor Score-Revised (MRFS-R).ResultsData were collected for 753 patients. The mean age was 81.9 ± 7.7 years, and 70.3% were women. The mean FI-Lab score was 0.34 ± 0.11. Based on the distribution of FI-Lab scores by quartiles, patients were categorized into four frailty groups: robust (FI-Lab < 0.251), mild (0.252–0.333), moderate (0.334–0.407), and severe (>0.409). No association was found between FI-Lab and MRFS-R as a continuous variable (Spearman r = −0.07, p = 0.054). A very weak correlation was found between FI-Lab and the length of stay in the Geriatric Department (Spearman r = 0.08, p = 0.022). After adjusting for age, sex, comorbidity, and complications during hospitalization, patients with higher FI-Lab scores exhibited higher mortality rates. For each 0.01 increase in the FI-Lab score (as a continuous variable), adjusted analyses revealed a 3.6% increase in all-cause mortality within the first year after hospitalization, and a 2.7% increase in all-cause mortality during median follow-up period of 2.2 years.ConclusionFI-Lab does not predict rehabilitation success, but does predict overall mortality among patients who underwent rehabilitation after a hip or pelvic fracture.
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spelling doaj-art-67fcfcd5a6a9484fa1e0a5fdf99153372025-08-20T03:13:10ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-07-011210.3389/fmed.2025.16270261627026FI-Lab predicts all-cause mortality, but not successful rehabilitation, among patients aged 65 and older after hip or pelvic fractureEvgeniya Zikrin0Evgeniya Zikrin1Abdu El Karim Hilali2Abdu El Karim Hilali3David Shacham4David Shacham5Reut Frenkel6Reut Frenkel7Olga Abel8Olga Abel9Muhammad Abo Abed10Muhammad Abo Abed11Ahmed Abu-Ajaj12Ahmed Abu-Ajaj13Natalia Velikiy14Natalia Velikiy15Tamar Freud16Tamar Freud17Tamar Freud18Yan Press19Yan Press20Yan Press21Yan Press22Yan Press23Yan Press24Faculty of Health Sciences, Ben-Gurion University of the Negev, Be’er-Sheva, IsraelDepartment of Geriatrics, Soroka Medical Center, Be’er-Sheva, IsraelFaculty of Health Sciences, Ben-Gurion University of the Negev, Be’er-Sheva, IsraelDepartment of Geriatrics, Soroka Medical Center, Be’er-Sheva, IsraelFaculty of Health Sciences, Ben-Gurion University of the Negev, Be’er-Sheva, IsraelDepartment of Geriatrics, Soroka Medical Center, Be’er-Sheva, IsraelFaculty of Health Sciences, Ben-Gurion University of the Negev, Be’er-Sheva, IsraelDepartment of Geriatrics, Soroka Medical Center, Be’er-Sheva, IsraelFaculty of Health Sciences, Ben-Gurion University of the Negev, Be’er-Sheva, IsraelDepartment of Geriatrics, Soroka Medical Center, Be’er-Sheva, IsraelFaculty of Health Sciences, Ben-Gurion University of the Negev, Be’er-Sheva, IsraelDepartment of Geriatrics, Soroka Medical Center, Be’er-Sheva, IsraelFaculty of Health Sciences, Ben-Gurion University of the Negev, Be’er-Sheva, IsraelDepartment of Geriatrics, Soroka Medical Center, Be’er-Sheva, IsraelFaculty of Health Sciences, Ben-Gurion University of the Negev, Be’er-Sheva, IsraelDepartment of Geriatrics, Soroka Medical Center, Be’er-Sheva, IsraelFaculty of Health Sciences, Ben-Gurion University of the Negev, Be’er-Sheva, IsraelSiaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be’er-Sheva, IsraelDivision of Community Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be’er-Sheva, IsraelFaculty of Health Sciences, Ben-Gurion University of the Negev, Be’er-Sheva, IsraelDepartment of Geriatrics, Soroka Medical Center, Be’er-Sheva, IsraelSiaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be’er-Sheva, IsraelDivision of Community Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be’er-Sheva, IsraelUnit for Community Geriatrics, Division of Health in the Community, Ben-Gurion University of the Negev, Be’er-Sheva, IsraelCenter for Multidisciplinary Research in Aging, Ben-Gurion University of the Negev, Be’er-Sheva, IsraelPurposeOver the past decade, the Frailty Index based on Laboratory data (FI-Lab index) has been effective in predicting complications during hospitalization, length of hospital stay, changes in functional status, and even mortality. The aims of the present study were to examine the associations between FI-Lab, rehabilitation outcomes, and mortality following hip and pelvic fractures.MethodsA retrospective study of patients 65 years of age and above who underwent rehabilitation after hip or pelvic fracture in the Geriatric Department, between January 2018 and December 2024. Data included demographic variables, comorbidity, and all-cause mortality. The FI-Lab was calculated based on 26 available blood tests, as well as blood pressure and heart rate measurements. Rehabilitation outcomes were measured using the Montebello Rehabilitation Factor Score-Revised (MRFS-R).ResultsData were collected for 753 patients. The mean age was 81.9 ± 7.7 years, and 70.3% were women. The mean FI-Lab score was 0.34 ± 0.11. Based on the distribution of FI-Lab scores by quartiles, patients were categorized into four frailty groups: robust (FI-Lab < 0.251), mild (0.252–0.333), moderate (0.334–0.407), and severe (>0.409). No association was found between FI-Lab and MRFS-R as a continuous variable (Spearman r = −0.07, p = 0.054). A very weak correlation was found between FI-Lab and the length of stay in the Geriatric Department (Spearman r = 0.08, p = 0.022). After adjusting for age, sex, comorbidity, and complications during hospitalization, patients with higher FI-Lab scores exhibited higher mortality rates. For each 0.01 increase in the FI-Lab score (as a continuous variable), adjusted analyses revealed a 3.6% increase in all-cause mortality within the first year after hospitalization, and a 2.7% increase in all-cause mortality during median follow-up period of 2.2 years.ConclusionFI-Lab does not predict rehabilitation success, but does predict overall mortality among patients who underwent rehabilitation after a hip or pelvic fracture.https://www.frontiersin.org/articles/10.3389/fmed.2025.1627026/fullFI-Labrehabilitationmortalityhip fracturepelvic fracturepredictors
spellingShingle Evgeniya Zikrin
Evgeniya Zikrin
Abdu El Karim Hilali
Abdu El Karim Hilali
David Shacham
David Shacham
Reut Frenkel
Reut Frenkel
Olga Abel
Olga Abel
Muhammad Abo Abed
Muhammad Abo Abed
Ahmed Abu-Ajaj
Ahmed Abu-Ajaj
Natalia Velikiy
Natalia Velikiy
Tamar Freud
Tamar Freud
Tamar Freud
Yan Press
Yan Press
Yan Press
Yan Press
Yan Press
Yan Press
FI-Lab predicts all-cause mortality, but not successful rehabilitation, among patients aged 65 and older after hip or pelvic fracture
Frontiers in Medicine
FI-Lab
rehabilitation
mortality
hip fracture
pelvic fracture
predictors
title FI-Lab predicts all-cause mortality, but not successful rehabilitation, among patients aged 65 and older after hip or pelvic fracture
title_full FI-Lab predicts all-cause mortality, but not successful rehabilitation, among patients aged 65 and older after hip or pelvic fracture
title_fullStr FI-Lab predicts all-cause mortality, but not successful rehabilitation, among patients aged 65 and older after hip or pelvic fracture
title_full_unstemmed FI-Lab predicts all-cause mortality, but not successful rehabilitation, among patients aged 65 and older after hip or pelvic fracture
title_short FI-Lab predicts all-cause mortality, but not successful rehabilitation, among patients aged 65 and older after hip or pelvic fracture
title_sort fi lab predicts all cause mortality but not successful rehabilitation among patients aged 65 and older after hip or pelvic fracture
topic FI-Lab
rehabilitation
mortality
hip fracture
pelvic fracture
predictors
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1627026/full
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