Frailty: An indicator for poor outcomes among in-hospital pulmonology patients

Abstract

Background: Frailty is a clinical state in which there is in increase in an individual’s vulnerability for developing an increased dependency and/or mortality when exposed to a stressor. Identification and management of frailty is an important priority in clinical practice. FRAIL scale is one of the many screening instruments for frailty. Our aim is to assess FRAIL scale and its relations with outcome measures inpatient pulmonology patients

Methods: We included patients admitted to a tertiary care pulmonary diseases ward between 1November2019- 30May2020. We measured nutrition status by Mini Nutritional Assessment(MNA)questionnaire and hand-grip strength by hand dynamometer. Patients were classified according to FRAIL scale:patients with 0 point were classified as robust, 1-2points as prefrail and ≥3points as frail

Results: 94patients with median age of 57.5±18. 4years old were included in the study. 3 (34.7%)patients were hospitalized with pneumonia, 16(16.8%)patients with COPD and15(15.8%)patients with pleural effusion. FRAIL scale was3[2-4]for study population. Patients with 0-2 points were classified as non-frail and with≥3points as frail. Frail patients were older(p=0.02),had more comorbidities(p<0.001),had worse hand-grip strength(p=0.01), smaller arm(0.01) and calf perimeter(p=0.02)compared to non-frail patients. Frail patients were malnutrished according to MNA scores(p=0.02) and BMI(0.02). In-hospital mortality rate was 8.3%in frail patients however there were none among non-frail patients(p=0.09)

Conclusion: FRAIL scale is an easy to perform frailty questionnaire and frailty defined by this scale is associated with worse nutritional status, weaker grip strength and increased mortality in hospitalized patients