Comparison of a Frailty Risk Score and Comorbidity Indices for Hospital Readmission Using Electronic Health Record Data

The purpose of the current study was to investigate the predictive properties of five definitions of a frailty risk score (FRS) and three comorbidity indices using data from electronic health records (EHRs) of hospitalized adults aged ≥50 years for 3-day, 7-day, and 30-day readmission, and to identi...

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Bibliographic Details
Published in:Research in gerontological nursing 2021-03, Vol.14 (2), p.1-103
Main Authors: Lekan, Deborah A, McCoy, Thomas P, Jenkins, Marjorie, Mohanty, Somya, Manda, Prashanti, Yasin, Reham
Format: Article
Language:English
Subjects:
Biomarkers
Care and treatment
Chronic illnesses
Comorbidity
Cost estimates
Electronic health records
Frail elderly
Frailty
Geriatrics
Group homes
Health aspects
Health care policy
Hispanic people
Hospitalization
Hospitals
Medicaid
Medical records
Medicare
Methods
Mortality
Nursing
Nursing homes
Older people
Patient safety
Primary care
Risk assessment
Sociodemographics
Womens health
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Summary:The purpose of the current study was to investigate the predictive properties of five definitions of a frailty risk score (FRS) and three comorbidity indices using data from electronic health records (EHRs) of hospitalized adults aged ≥50 years for 3-day, 7-day, and 30-day readmission, and to identify an optimal model for a FRS and comorbidity combination. Retrospective analysis of the EHR dataset was performed, and multivariable logistic regression and area under the curve (AUC) were used to examine readmission for frailty and comorbidity. The sample (N = 55,778) was mostly female (53%), non-Hispanic White (73%), married (53%), and on Medicare (55%). Mean FRSs ranged from 1.3 (SD = 1.5) to 4.3 (SD = 2.1). FRS and comorbidity were independently associated with readmission. Predictive accuracy for FRS and comorbidity combinations ranged from AUC of 0.75 to 0.77 (30-day readmission) to 0.84 to 0.85 (3-day readmission). FRS and comorbidity combinations performed similarly well, whereas comorbidity was always independently associated with readmission. FRS measures were more associated with 30-day readmission than 7-day and 3-day readmission. [Research in Gerontological Nursing, xx(x), xx-xx.].
ISSN:1940-4921
1938-2464
DOI:10.3928/19404921-20210115-03