Background: Frailty constitutes a major factor that puts the elderly at risk of health and functional deterioration.
Objectives: To develop and validate an Electronic Frailty Index based on electronic data routinely collected in the HMO.
Study Design And Setting: A retrospective cohort of the HMO members.
Participants: 120,986 patients, aged 65 years and over at the beginning of 2023.
Predictors: A cumulative frailty index including 36 medical, functional, and social deficits.
Outcomes: One-year all-cause mortality or hospitalization.
Statistical Analysis: One-year hazard ratios were estimated for composite outcome of mortality or hospitalization using multivariable hierarchical Cox regression.
Results: The mean EFI score increased with the Social Security Nursing Benefit. Compared to fit patients, mild, moderate, and severe frailty patients had 2.07, 3.35, and 4.4-fold increased risks of mortality or hospitalization, after controlling for covariates.
Conclusions: The findings showed that the Electronic Frailty Index version we created is valid in predicting mortality or hospitalization. In addition, the Electronic Frailty Index converged with an independent measurement produced by National Social Security.
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http://dx.doi.org/10.18632/aging.206141 | DOI Listing |
Am J Surg
December 2024
Division of Acute Care Surgery, Department of Surgery, USA. Electronic address:
Background: The impact of frailty on outcomes in midlife trauma patients (50-64 y) remains understudied. We evaluated the impact of frailty on midlife trauma patients' outcomes.
Methods: This is a retrospective cohort study using TQIP 2021 data.
Clin Nutr
December 2024
Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy; Geriatric Clinic, Maggiore University Hospital, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Trieste, Italy; School of Dietetics, University of Trieste - Pordenone branch, Pordenone, Italy.
Background & Aims: Malnutrition and cognitive impairment are among the major contributors to frailty, that significantly increases the risk of mortality of older hospitalized patients. Multidimensional frailty assessment tools, such as the multidimensional prognostic index-MPI, a tool based on a standard comprehensive geriatric assessment (CGA), have proven valuable for predicting adverse outcomes, including mortality of older adults following acute illness but its application in everyday clinical practice is limited. We hypothesized that removing parameters not closely associated with mortality and sorting the patient population according to the presence or not of cognitive impairment with possible integration of common laboratory markers, could provide a simplified approach that could improve practicability in all settings with at least comparable 1-year mortality predictive value.
View Article and Find Full Text PDFCurr Oncol
December 2024
Breast Center, São João University Hospital (ULS São João), 4200-319 Porto, Portugal.
(1) Background: Breast cancer (BC) has a high incidence in Europe, particularly in older adults. Traditionally under-represented in clinical trials, this age group is often undertreated due to ageism. This study aims to characterize frail older adults (≥70 years) with BC based on a comprehensive geriatric assessment, to guide individualized treatment decision-making.
View Article and Find Full Text PDFEpidemiologia (Basel)
December 2024
Institute of General Practice and Public Health, Claudiana-College of Health Professions, 39100 Bolzano, Italy.
Ministerial Decree (D.M.) 77/2022 aims to reform Italy's primary care system by establishing community health centres and integrating digital tools to address healthcare access disparities and workforce shortages.
View Article and Find Full Text PDFJ Vasc Surg
December 2024
Department of Surgery; Baptist Health South Florida at Boca Raton Regional Hospital, Boca Raton, Florida. Electronic address:
Objective: Enhanced Recovery After Surgery (ERAS) clinical pathways have demonstrated improved perioperative outcomes after major surgery. However, its adoption within vascular surgery has been limited. In this study, we examined the impact of an ERAS protocol with multimodal anesthesia on open abdominal aortic aneurysm (AAA) repair by comparing early outcomes before and after its implementation.
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