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

• A prospective analysis in a cohort of hospitalized geriatric patients.
• We compared the ability of five frailty scales in predicting one-year mortality.
• All five frailty scales predicted one-year mortality.
• The Clinical Frailty Scale was the most powerful predictor for mortality.
• Using these frailty scales might improve decision making in geriatric inpatients.

BackgroundData comparing the ability of different major frailty instruments for predicting mortality in hospitalized geriatric patients are scare.Material and methods307 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.ResultsFollow-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).ConclusionAmong those frailty instruments that were evaluated, the CFS-9 emerged as the most powerful for prediction of one-year mortality.