Prediction of one-year mortality by five different frailty instruments: A comparative study in hospitalized geriatric patients

Background: Data comparing the ability of different major frailty instruments for predicting mortality in hospitalized geriatric patients are scare. Material and methods: 307 patients >= 65 years who were hospitalized on geriatric wards were included in this prospective analysis. A fifty-item frailty index (FI), a ten-domain + co-morbidity frailty index based on a standardized comprehensive geriatric assessment (FI-CGA), the nine category Clinical Frailty Scale (CFS-9), the CSHA rules-based frailty definition (CSHA-RBFD), and the frailty phenotype (FP) were assessed during the patients' hospital stays. Patients were followed up over a one-year period. Results: Follow-up data after one year could be obtained from 305 out of the 307 participants. Sixty two participants (20.3%) had died after that time. The FI, FI-CGA, CFS-9, CSHA-RBFD, and FP could all discriminate between patients who died and those who survived during follow-up (areas under the ROC curves: 0.805, 0.808, 0.852, 0.703 and 0.757, all P < 0.001, respectively). The CFS-9 showed a better discriminative ability for one-year mortality compared to the FI, FI-CGA, CSHA-RBFD, and FP (all P < 0.05, respectively). The FI and the FI-CGA did not differ in their discriminative ability for one-year mortality (P = 0.440). The CSHA-RBFD and the FP demonstrated a comparable discriminative ability (P = 0.241) and, when compared to the CFS-9, FI, and FI-CGA, an inferior discriminative ability for one-year mortality (all P < 0.05, respectively). Conclusion: Among those frailty instruments that were evaluated, the CFS-9 emerged as the most powerful for prediction of one-year mortality. (C) 2016 Elsevier Ireland Ltd. All rights reserved.