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Citation
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Middleton R, Poveda JL, Orfila Pernas F, Martinez Laguna D, Diez Perez A, Nogués X, Carbonell Abella C, Reyes C, Prieto-Alhambra D. J. Gerontol. A Biol. Sci. Med. Sci. 2021; ePub(ePub): ePub. |
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Abstract
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BACKGROUND: Frail subjects are at increased risk of adverse outcomes. We aimed to assess their risk of falls, all-cause mortality, and fractures.
METHODS: We used a retrospective cohort study using the SIDIAP database (>6 million residents). Subjects ≥75 years old with ≥1 year of valid data (2007- 2015) were included. Follow-up: from (the latest of) date of cohort entry up to migration, end of the study period or outcome (whichever came first). The eFRAGICAP classified subjects as Fit, Mild, Moderate or Severely Frail. Outcomes (ICD-10) were incident falls, fractures (overall/hip/vertebral) and all-cause mortality during the study period. Statistics: Hazard Ratios (HR), 95% CI adjusted (per age, sex and socio-economic status) and un-adjusted cause-specific Cox models, accounting for competing risk of death (Fit group as the reference).
RESULTS: 893,211 subjects were analyzed. 54.4% were classified as Fit, 34.0% as mild, 9.9% as moderate and 1.6% as severely frail. Compared with the fit, frail had an increased risk of falls (adjusted HR of 1.55 (1.52-1.58), 2.74 (2.66-2.84) and 5.94 (5.52-6.40)), all-cause mortality (adjusted HR of 1.36 (1.35-1.37), 2.19 (2.16-2.23) and 4.29 (4.13-4.45)) and fractures (adjusted HR of 1.21(1.20-1.23), 1.51(1.47-1.55) and 2.36 (2.20-2.53)) for mild, moderate and severe frailty respectively. Severely frail had a high risk of vertebral (HR of 2.49 (1.99-3.11)) and hip fracture (HR of 1.85 (1.50-2.28)). Accounting for competing risk of death unchanged results.
CONCLUSION: Frail subjects are at increased risk of death, fractures and falls. The eFRAGICAP tool can easily assess frailty in electronic primary-care databases in Spain.
Language: en |