PT  - JOURNAL ARTICLE
AU  - Sharry Kahlon
AU  - Jenelle Pederson
AU  - Sumit R. Majumdar
AU  - Sara Belga
AU  - Darren Lau
AU  - Miriam Fradette
AU  - Debbie Boyko
AU  - Jeffrey A. Bakal
AU  - Curtis Johnston
AU  - Raj S. Padwal
AU  - Finlay A. McAlister
TI  - Association between frailty and 30-day outcomes after discharge from hospital
AID  - 10.1503/cmaj.150100
DP  - 2015 Jan 01
TA  - Canadian Medical Association Journal
PG  - cmaj.150100
4099  - http://www.cmaj.ca/content/early/2015/05/25/cmaj.150100.short
4100  - http://www.cmaj.ca/content/early/2015/05/25/cmaj.150100.full
AB  - Background: Readmissions after hospital discharge are common and costly, but prediction models are poor at identifying patients at high risk of readmission. We evaluated the impact of frailty on readmission or death within 30 days after discharge from general internal medicine wards. Methods: We prospectively enrolled patients discharged from 7 medical wards at 2 teaching hospitals in Edmonton. Frailty was defined by means of the previously validated Clinical Frailty Scale. The primary outcome was the composite of readmission or death within 30 days after discharge. Results: Of the 495 patients included in the study, 162 (33%) met the definition of frailty: 91 (18%) had mild, 60 (12%) had moderate, and 11 (2%) had severe frailty. Frail patients were older, had more comorbidities, lower quality of life, and higher LACE scores at discharge than those who were not frail. The composite of 30-day readmission or death was higher among frail than among nonfrail patients (39 [24.1%] v. 46 [13.8%]). Although frailty added additional prognostic information to predictive models that included age, sex and LACE score, only moderate to severe frailty (31.0% event rate) was an independent risk factor for readmission or death (adjusted odds ratio 2.19, 95% confidence interval 1.12-4.24). Interpretation: Frailty was common and associated with a substantially increased risk of early readmission or death after discharge from medical wards. The Clinical Frailty Scale could be useful in identifying high-risk patients being discharged from general internal medicine wards.