External validation of the Hospital Frailty Risk Score in France

<h4>Background: The Hospital Frailty Risk Score (HFRS) has made it possible internationally to identify subgroups of patients</h4><h4>with characteristics of frailty from routinely collected hospital data.</h4><h4>Objective: To externally validate the HFRS in France.</h4><h4>Design: A retrospective analysis of the French medical information database.</h4><h4>Setting: 743 hospitals in Metropolitan France.</h4><h4>Subjects: All patients aged 75 years or older hospitalised as an emergency in 2017 (n = 1,042,234).</h4><h4>Methods: The HFRS was calculated for each patient based on the index stay and hospitalisations over the preceding 2 years.</h4><h4>Main outcome measures were 30-day in-patient mortality, length of stay (LOS) >10 days and 30-day readmissions. Mixed</h4><h4>logistic regression models were used to investigate the association between outcomes and HFRS score.</h4><h4>Results: Patients with high HFRS risk were associated with increased risk of mortality and prolonged LOS (adjusted odds</h4><h4>ratio [aOR] = 1.38 [1.35–1.42] and 3.27 [3.22–3.32], c-statistics = 0.676 and 0.684, respectively), while it appeared less</h4><h4>predictive of readmissions (aOR = 1.00 [0.98–1.02], c-statistic = 0.600). Model calibration was excellent. Restricting the</h4><h4>score to data prior to index admission reduced discrimination of HFRS substantially.</h4><h4>Conclusions: HFRS can be used in France to determine risks of 30-day in-patient mortality and prolonged LOS, but not</h4><h4>30-day readmissions. Trial registration: Reference ID on clinicaltrials.gov: ID: NCT03905629.</h4><h4></h4>