Comparison between FRAIL Scale and Clinical Frailty Scale in predicting hospitalization in hemodialysis patients

• Published in: Journal of nephrology Vol. 36; no. 3; pp. 687 - 693
• Main Authors: Barbosa, Elisabete Mouzinho Soares, Pereira, Amanda Gomes, Mori, Vitória, da Silva Neves, Renan, Vieira, Nayane Maria, Silva, Maryanne Zilli Canedo, Seki, Marcos Mitsuo, Rodrigues, Hellen Christina Neves, Costa, Nara Aline, Ponce, Daniela, Balbi, André Luís, Zornoff, Leonardo Antonio Mamede, Azevedo, Paula Schmidt, Polegato, Bertha Furlan, de Paiva, Sérgio Alberto Rupp, Minicucci, Marcos Ferreira, de Souza Dorna, Mariana
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.04.2023
• Subjects: Adolescent; Aged; Female; Frail Elderly; Frailty - epidemiology; Hospitalization; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Nephrology; Original; Original Article; Prospective Studies; Renal Dialysis; Urology; Frailty; Scales; Hospitalization; Hemodialysis
• ISSN: 1724-6059; 1121-8428; 1724-6059
• DOI: 10.1007/s40620-022-01532-5

Background To assess the prevalence of frailty by the Clinical Frailty Scale (CFS) and the 5-item FRAIL scale and their association with hospitalization in hemodialysis (HD) patients. Methods This was a prospective observational study. We included patients of both genders ≥ 18 years old in HD treatment for at least 3 months. Demographic, clinical, and routine laboratory data were retrieved from the medical charts. Two different frailty assessment tools were used, the CFS and the FRAIL scale. Participants were followed up for 9 months and hospitalizations for all causes were evaluated. A Venn diagram was constructed to show the overlap of possible frailty and pre-frailty. Cox regression was used to identify the association between frailty and hospitalization. The significance level was 5%. Results A total of 137 subjects were included in the analysis. The median age was 61 (52–67) years and 60% were male. The hospitalization rate and mortality in 9 months were 22.6% and 7.29%, respectively. Regarding frailty, the overall prevalence was 13.8% assessed by CFS and 36.5% according to the FRAIL scale. In the Cox regression, frailty by FRAIL scale was associated with a 2.8-fold increase in the risk of hospitalization (OR = 2.880; 95% CI = 1.361–6.096; p  = 0.006), but frailty assessed by the CFS was not associated with the need for hospitalization. Conclusion In HD patients, the FRAIL scale proved to be an easy-to-apply tool, identifying a high prevalence of frailty and being a predictor of hospital admission. Graphical abstract