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Ann Rehabil Med  <  Volume 22(1); 2018 <  Articles

Ann Geriatr Med Res 2018; 22(1): 20-25  https://doi.org/10.4235/agmr.2018.22.1.20
Use of the Frailty Index and FRAIL-NH Scale for the Assessment of the Frailty Status of Elderly Individuals Admitted in a Long-term Care Hospital in Korea
Hyuk Ga1, Chang Won Won2, Hee-Won Jung3
1Institute of Geriatric Medicine, Incheon Eun-Hye Hospital, Incheon, 2Elderly Frailty Research Center, Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, 3Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Korea
Correspondence to: Hee-Won Jung, MD
Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291, Daehak-ro, Yuseong-gu, Daejeon 34141, Korea
Tel: +82-42-350-4283
Fax:+82-42-350-4269
E-mail: dr.ecsta@gmail.com
Received: November 27, 2017; Revised: December 27, 2017; Accepted: January 27, 2018; Published online: March 31, 2018.
© The Korea Geriatrics Society. All rights reserved.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Numerous elderly individuals with multimorbidity and impaired function are admitted in long-term care hospitals (LTCHs) in Korea. In this study, we aimed to describe the frailty status of elderly patients admitted in a LTCH using the FRAIL-NH scale and to identify the clinical relevance of frailty status on clinical outcomes, including death.
Methods: We retrospectively reviewed the medical records of 100 elderly patients who were hospitalized and died in an LTCH from March 2011 to February 2017. The monthly assessment results obtained from the inpatients’ data set (IDS) were used as main data sources for the 6-item FRAIL-NH scale and frailty index that was composed of 22 newly established items.
Results: The mean frailty index of the patients included in the analysis (mean age, 81.5±7.2 years; men, 53%) was 0.60 (standard deviation [SD], 0.10; range, 0.28-0.80). The distribution of the FRAIL-NH score in this population was in accordance with the 22-item frailty index, which shows a standardized beta of 0.571 (p<0.001, R=0.572). When the patients were categorized based on the FRAIL-NH score, the mean survival durations of the more fail group (FRAIL-NH >10, n=49) and less frail group (FRAIL-NH ≤10, n=51) were 529.3 days (SD, 453.4) and 888 days (SD, 679.9), respectively. Similarly, the frailty index was associated with earlier mortality.
Conclusion: Frailty is extremely common in elderly patients admitted in an LTCH and can be easily measured using the FRAIL-NH scale that utilizes the IDS of LTCHs in Korea. Since frailty is associated with earlier mortality, the assessment of frailty status in patients admitted in LTCHs may be helpful in clinical decision-making.
Keywords: Frail elderly, Frailty index, Long-term care, Aged care facilities


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