Frailty in older adults admitted to hospital: outcomes from the Western Sydney Clinical Frailty Registry

Abstract Objectives To examine baseline frailty and its association with rehospitalisation and mortality within 12 months among older adults enrolled in the Western Sydney Clinical Frailty Registry. Design Prospective observational cohort study. Setting and participants 592 adults admitted to an acu...

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Main Authors: Julee McDonagh, Richard I Lindley, Karen Byth, Reejamol John, Caleb Ferguson
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Geriatrics
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Online Access:https://doi.org/10.1186/s12877-025-05715-0
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author Julee McDonagh
Richard I Lindley
Karen Byth
Reejamol John
Caleb Ferguson
author_facet Julee McDonagh
Richard I Lindley
Karen Byth
Reejamol John
Caleb Ferguson
author_sort Julee McDonagh
collection DOAJ
description Abstract Objectives To examine baseline frailty and its association with rehospitalisation and mortality within 12 months among older adults enrolled in the Western Sydney Clinical Frailty Registry. Design Prospective observational cohort study. Setting and participants 592 adults admitted to an acute geriatric medicine service in NSW, Australia, were included in this study. Methods The Western Sydney Clinical Frailty Registry is a study of adults admitted to acute geriatric wards in a 570-bed two-site district general hospital in Western Sydney, NSW, Australia. Recruitment began in April 2020 and is ongoing. Each participant is recruited while an inpatient and followed up for 12 months, including baseline visits and three-, six- and 12-month follow-ups via telephone interviews. The primary outcome of this study was rehospitalisation and/or mortality at 12 months. Results Median age 82 years; half the cohort were classified as mild-moderately frail, and 21% were classified as severely frail. A total of 134 participants died (22.6%) within the 12-month follow-up period. Increased cumulative incidence of first rehospitalisation and/or death during the first 12 months post-discharge was significantly associated with higher modified Charlson comorbidity (p < 0.001) and Clinical Frailty Scale (CFS) scores (p < 0.001). Compared to the ‘non-frail’ group (CFS 1–4), those who were severely frail (CFS 7–9) had an 85% increased risk of rehospitalisation and/or death (95% CI 1.36–2.52), and those who were mild-moderately frail (CFS 5–6) had a 52% increased risk after adjusting for effects of the other variables (95% CI 1.18–1.94). Conclusions Frailty is very common in older adults admitted to acute geriatric services. Assessing frailty using the CFS is feasible and is independently predictive of rehospitalisation and mortality. Our findings suggest that integrating frailty assessment into clinical practice goes beyond simple risk stratification, offering valuable insights for tailored clinical management strategies.
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spelling doaj-art-d850fdfd40224bcd945812a583b775fa2025-02-09T12:53:27ZengBMCBMC Geriatrics1471-23182025-02-0125111010.1186/s12877-025-05715-0Frailty in older adults admitted to hospital: outcomes from the Western Sydney Clinical Frailty RegistryJulee McDonagh0Richard I Lindley1Karen Byth2Reejamol John3Caleb Ferguson4School of Nursing, Faculty of Science, Medicine & Health, University of WollongongCentre for Chronic and Complex Care Research, Blacktown Hospital, Western Sydney Local Health DistrictWestern Sydney Local Health District, Research and Education NetworkCentre for Chronic and Complex Care Research, Blacktown Hospital, Western Sydney Local Health DistrictSchool of Nursing, Faculty of Science, Medicine & Health, University of WollongongAbstract Objectives To examine baseline frailty and its association with rehospitalisation and mortality within 12 months among older adults enrolled in the Western Sydney Clinical Frailty Registry. Design Prospective observational cohort study. Setting and participants 592 adults admitted to an acute geriatric medicine service in NSW, Australia, were included in this study. Methods The Western Sydney Clinical Frailty Registry is a study of adults admitted to acute geriatric wards in a 570-bed two-site district general hospital in Western Sydney, NSW, Australia. Recruitment began in April 2020 and is ongoing. Each participant is recruited while an inpatient and followed up for 12 months, including baseline visits and three-, six- and 12-month follow-ups via telephone interviews. The primary outcome of this study was rehospitalisation and/or mortality at 12 months. Results Median age 82 years; half the cohort were classified as mild-moderately frail, and 21% were classified as severely frail. A total of 134 participants died (22.6%) within the 12-month follow-up period. Increased cumulative incidence of first rehospitalisation and/or death during the first 12 months post-discharge was significantly associated with higher modified Charlson comorbidity (p < 0.001) and Clinical Frailty Scale (CFS) scores (p < 0.001). Compared to the ‘non-frail’ group (CFS 1–4), those who were severely frail (CFS 7–9) had an 85% increased risk of rehospitalisation and/or death (95% CI 1.36–2.52), and those who were mild-moderately frail (CFS 5–6) had a 52% increased risk after adjusting for effects of the other variables (95% CI 1.18–1.94). Conclusions Frailty is very common in older adults admitted to acute geriatric services. Assessing frailty using the CFS is feasible and is independently predictive of rehospitalisation and mortality. Our findings suggest that integrating frailty assessment into clinical practice goes beyond simple risk stratification, offering valuable insights for tailored clinical management strategies.https://doi.org/10.1186/s12877-025-05715-0FrailtyClinical Frailty ScaleOlder adultsRehospitalisationMortality
spellingShingle Julee McDonagh
Richard I Lindley
Karen Byth
Reejamol John
Caleb Ferguson
Frailty in older adults admitted to hospital: outcomes from the Western Sydney Clinical Frailty Registry
BMC Geriatrics
Frailty
Clinical Frailty Scale
Older adults
Rehospitalisation
Mortality
title Frailty in older adults admitted to hospital: outcomes from the Western Sydney Clinical Frailty Registry
title_full Frailty in older adults admitted to hospital: outcomes from the Western Sydney Clinical Frailty Registry
title_fullStr Frailty in older adults admitted to hospital: outcomes from the Western Sydney Clinical Frailty Registry
title_full_unstemmed Frailty in older adults admitted to hospital: outcomes from the Western Sydney Clinical Frailty Registry
title_short Frailty in older adults admitted to hospital: outcomes from the Western Sydney Clinical Frailty Registry
title_sort frailty in older adults admitted to hospital outcomes from the western sydney clinical frailty registry
topic Frailty
Clinical Frailty Scale
Older adults
Rehospitalisation
Mortality
url https://doi.org/10.1186/s12877-025-05715-0
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