Outcomes of FRAIL-NH in an acute residential aged care geriatric medicine InReach service.

BACKGROUND AND AIMS: The FRAIL-NH scale assesses frailty in people residing in residential aged care homes (RACHs). Residential InReach (RIR) is a service that provides acute assessment and intervention for RACH residents. We examined whether FRAIL-NH predicts mortality, hospital presentation and RIR involvement for people living in RACHs who require RIR input.

SETTING AND

PARTICIPANTS

Single-centre, retrospective, observational cohort study reviewed by RIR between April 2020 and November 2021 in Melbourne, Australia.

METHODS

FRAIL-NH scores were collected for residents seen by RIR. The data were collated retrospectively via medical records. The association between FRAIL-NH scores and outcomes of mortality, all-cause hospitalization and RIR re-referral was assessed for 28 days, 6 months and 12 months from RIR review.

RESULTS

Of 414 patients, 86% were considered frail. FRAIL-NH≥8 was associated with mortality at 28 days, 6 months and 12 months (adjusted hazard ratio (HR), 28 days: 2.00 (95% confidence interval (CI), 1.26-3.17), P = 0.003; 6 months: HR, 2.19 (95% CI, 1.56-3.08, P < 0.001); 12 months: HR, 1.91 (95% CI, 1.44-2.55), P < 0.001). For each increase of one point in FRAIL-NH score, the risk of mortality increased by 13% (28 days: HR, 1.13 (95% CI, CI), P = 0.002), 15% (6 months: HR, 1.15 (95% CI, CI) P < 0.001) and 14% (12 months: HR, 1.14 (95% CI, XX) P < 0.01). FRAIL-NH did not predict all-cause hospitalisation/RIR review at 28 days and 6 months (P = 0.918 and P = 0.121 respectively).

CONCLUSIONS

This study confirms the utility of the FRAIL-NH score as being independently associated with mortality. Results demonstrate the potential benefits of screening for frailty in clinical services providing acute care to vulnerable populations. Identifying frail residents could assist in tailoring care/interventions, prioritising advance care planning/goals of care discussions and allocation of resources.