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Table 2 Frailty charactseristics of included articles

From: What do we know about frailty in the acute care setting? A scoping review

  All Geriatrics Emergency Department General Medicine Cardiology Orthopedics Intensive Care Unit Oncology Surgery Prehospital General Medicine & Surgery General Medicine & Geriatrics Geriatrics & Oncology
Articles n (%) 240 (100) 29 (12.1) 29 (12.1) 22 (9.2) 20 (8.3) 11 (4.6) 9 (3.8) 6 (3) 5 (2.1) 2 (0.8) 18 (7.5) 7 (2.9) 2 (0.8)
When was frailty measured n (%)
 At admission 94 (46.1) 15 (51.7) 18 (62.1) 12 (54.5) 6 (30.0) 3 (27.3) 5 (55.6) 3 (50.0) 3 (60.0) 0 3 (16.7) 6 (85.7) 1 (50.0)
 During hospitalization 34 (16.7) 9 (31.0) 3 (10.3) 5 (22.7) 4 (20.0) 2 (18.2) 1 (11.1) 2 (33.3) 0 1 (50.0) 3 (16.7) 0 0
 At discharge 10 (4.9) 1 (3.4) 1 (3.4) 0 3 (15.0) 0 1 (11.1) 0 0 0 0 0 0
 Mixeda 13 (6.4) 1 (3.4) 3 (10.3) 2 (9.0) 0 1 (9.1) 0 1 (16.7) 0 0 0 1 (14.3) 0
 Chart/Database review 27 (13.2) 3 (10.3) 3 (10.3) 2 (9.1) 6 (30.0) 3 (27.3) 2 (22.2) 0 1 (20.0) 1 (50.0) 1 (5.6) 0 0
 Not reported 26 (12.7) 0 1 (3.4) 1 (4.5) 1 (5.0) 2 (18.2) 0 0 1 (20.0) 0 11 (61.1) 0 1 (50.0)
Number of frailty measures used n (%)
 1 185 (90.7) 25 (86.2) 27 (93.1) 21 (95.5) 16 (80.0) 8 (72.7) 8 (88.9) 6 (100.0) 4 (80.0) 2 (100.0) 18 (100.0) 7 (100.0) 2 (100.0)
 2 9 (4.4) 3 (10.3) 0 0 4 (20.0) 0 1 (11.1) 0 0 0 0 0 0
 3 5 (2.5) 0 2 (6.9) 1 (4.5) 0 2 (18.2) 0 0 0 0 0 0 0
 4 4 (2.0) 1 (3.4) 0 0 0 1 (9.1) 0 0 0 0 0 0 0
 6 1 (0.5) 0 0 0 0 0 0 0 1 (20.0) 0 0 0 0
Type of frailty measure n (%)
 Established frailty tools 123 (51.3) 17 (48.6) 17 (51.5) 17 (70.8) 16 (66.7) 6 (33.3) 9 (90.0) 3 (50.0) 6 (60.0) 1 (50.0) 0 6 (85.7) 1 (50.0)
 Non-frailty toolsb 57 (23.8) 11 (31.4) 13 (39.4) 4 (16.7) 3 (12.5) 10 (55.6) 0 1 (16.7) 4 (40.0) 0 1 (5.6) 0 0
 Ad hoc measuresc 56 (23.3) 6 (17.1) 3 (9.1) 3 (12.5) 4 (16.7) 2 (11.1) 1 (10.0) 2 (33.3) 0 1 (50.0) 15 (83.3) 1 (14.3) 1 (50.0)
 Clinical judgment 4 (1.7) 1 (2.9) 0 0 1 (4.2) 0 0 0 0 0 2 (11.1) 0 0
Frailty Measure used n (%)
Established frailty tools
  Clinical Frailty Scale 28 (11.7) 6 (17.1) 4 (12.1) 4 (16.7) 3 (12.5) 0 6 (60.0) 0 0 0 0 0 0
  Frailty Phenotype 28 (11.7) 2 (5.7) 4 (12.1) 4 (16.7) 6 (25.0) 1 (5.6) 2 (20.0) 0 2 (20.0) 0 0 1 (14.3) 0
  Frailty Index 28 (11.7) 3 (8.6) 7 (21.2) 4 (16.7) 1 (4.2) 4 (22.2) 1 (10.0) 0 1 (10.0) 1 (50.0) 0 1 (14.3) 0
  Edmonton Frailty Scale 10 (4.2) 0 2 (6.1) 2 (8.3) 2 (8.3) 1 (5.6) 0 0 0 0 0 0 0
  Winodgrad Index 7 (2.9) 0 0 1 (4.2 0 0 0 0 0 0 0 4 (57.1) 0
  Balducci criteria 5 (2.1) 0 0 0 0 0 0 3 (50.0) 1 (10.0) 0 0 0 1 (50.0)
  Rockwood Geriatric Frailty Status 5 (2.1) 2 (5.7) 0 0 1 (4.2) 0 0 0 1 (10.0) 0 0 0 0
  Study of Osteoporotic Fracture Index 3 (1.3) 2 (5.7) 0 1 (4.2) 0 0 0 0 0 0 0 0 0
  Tilburg Frailty Indicator 3 (1.3) 0 0 1 (4.2) 2 (8.3) 0 0 0 0 0 0 0 0
  FRAIL scale 2 (0.8) 1 (2.9) 0 0 1 (4.2) 0 0 0 0 0 0 0 0
  Groningen Frailty Indicator 2 (0.8) 0 0 0 0 0 0 0 1 (10.0) 0 0 0 0
  Other established toolsd 2 (0.8) 1 (2.9) 0 0 0 0 0 0 0 0 0 0 0
Non-frailty toolsb
  Identification of Seniors at Risk 12 (5.0) 4 (11.4) 3 (9.1) 2 (8.3) 1 (4.2) 1 (5.6) 0 0 0 0 0 0 0
  Vulnerable Elders Survey 5 (2.1) 0 3 (9.1) 0 0 0 0 0 1 (10.0) 0 0 0 0
  Grip strength 4 (1.7) 2 (5.7) 0 0 0 1 (5.6) 0 0 0 0 0 0 0
  Barthel Index 2 (0.8) 0 2 (6.1) 0 0 0 0 0 0 0 0 0 0
  Life Space Assessment 2 (0.8) 0 2 (6.1) 0 0 0 0 0 0 0 0 0 0
  Multidimensional Prognosis Index 2 (0.8) 2 (5.7) 0 0 0 0 0 0 0 0 0 0 0
  Short Physical Performance Battery 2 (0.8) 1 (2.9) 0 0 0 0 0 1 (16.7) 0 0 0 0 0
  Other non-frailty toolse 28 (11.7) 2 (5.7) 3 (9.1) 2 (9.1) 2 (8.3) 8 (44.4) 0 0 3 (30.0) 0 1 (5.6) 0 0
Ad hoc measuresc
  GEM criteriaf 12 (5.0) 0 0 0 0 0 0 0 0 0 12 (66.7) 0 0
  Other ad hoc measures 44 (18.3) 6 (17.1) 3 (9.1) 3 (12.5) 4 (16.7) 2 (11.1) 1 (10.0) 2 (33.3) 0 1 (50.0) 3 (16.7) 1 (14.3) 1 (50.0)
Clinical judgment 4 (1.7) 1 (2.9) 0 0 1 (4.2) 0 0 0 0 0 2 (11.1) 0 0
Purpose of frailty use n (%)
 Risk stratificationg 89 (43.6) 12 (41.4) 15 (51.7) 10 (45.5) 11 (55.0) 8 (72.7) 8 (88.9) 2 (33.3) 2 (40.0) 1 (50.0) 3 (16.7) 2 (28.6) 0
 Inclusion/Exclusion criterion 41 (20.1) 4 (13.8) 3 (10.3) 4 (18.2) 1 (5.0) 0 0 0 1 (20.0) 1 (50.0) 13 (72.2) 5 (71.4) 0
 Outcome measure 4 (2.0) 1 (3.4) 1 (3.4) 0 1 (5.0) 1 (9.1) 0 0 0 0 0 0 0
 Mixedh 3 (1.5) 0 0 2 (9.0) 0 0 0 1 (16.7) 0 0 0 0 0
 Only descriptivei 67 (32.8) 12 (41.4) 10 (34.5) 6 (27.3) 7 (35.0) 2 (18.2) 1 (11.1) 3 (50.0) 2 (40.0) 0 2 (11.1) 0 2 (100.0)
Prevalence of frailty (%)
 # of articles reporting 122 17 13 12 17 5 8 5 7 0 4 2 1
 Range 1.1–100 1.1–90.0 6.9–78.0 23.0–77.9 4.7–77.8 11.4–89.4 13.7–100 19.1–96.7 29.3–79.9 N/A 30.3–91.0 41.4–59.0 26.0
 Median (IQR) 48.5 (32.0–69.5) 43.3 (26.9–70.7) 46.7 (34.2–70.2) 51.3 (34.8–55.2) 35.5 (28.7–69) 68.5 (31.2–89.4) 33.5 (25.3–47.0 41.4 (26.7–81.0) 54.3 (50.0–70.7) N/A 45.3 (32.2–81.4) N/A N/A
Adverse outcomes predicted by frailty [n predicted/total measured (% predictive)]j
All adverse outcomes 169/228 (74.1) 23/30 (69.7) 25/32 (78.1) 18/22 (81.8) 15/19 (78.9) 11/16 (68.8) 22/33 (66.7) 4/8 (50) 11/14 (78.6) 1/1 (100) 4/4 (100) 2/3 (66.7) 0
Mortality 58/69 (84.1) 13/14 (92.9) 6/7 (85.7) 4/4 (100.0) 7/10 (70.0) 4/5 (80.0) 6/8 (75.0) 1/2 (50.0) 6/7 (85.7) 1/1 (100.0) 0 0 0
Length of stay 24/33 (72.7) 3/5 (60.0) 4/5 (80.0) 4/7 (57.1) 2/2 (100.0) 3/3 (100.0) 3/6 (50.0) 0 0 0 1/1 (100.0) 2/2 (100.0) 0
In-hospital complications 20/29 (69.0) 0 2/2 (100.0) 0 2/2 (100.0) 1/4 (25.0) 1/3 (33.3) 1/2 (50.0) 5/7 (71.4) 0 1/1 (100.0) 0 0
Institutionalization 27/29 (93.1) 1/1 (100.0) 6/6 (100.0) 7/7 (100.0) 1/1 (100.0) 1/1 (100.0) 5/7 (71.4) 1/1 (100.0) 0 0 0 0 0
Rehospitalization 9/18 (50.0) 3/4 (75.0) 3/5 (60.0) 0/1 (0) 1/1 (100.0) 0 0/1 (0) 0 0 0 1/1 (100.0) 0 0
Functional decline 8/8 (66.7) 2/2 (100.0) 2/4 (50.0) 1/1 (100.0) 0 0 3/3 (100.0) 0 0 0 0 0/1 (0) 0
Treatment changek 8/8 (66.7) 1/1 (100.0) 0/1 (0) 0 2/3 (66.7) 0 2/3 (66.7) 0/1 (0) 0 0 1/1 (100.0) 0 0
Falls 3/7 (42.9) 0/4 (0) 1/1 (100.0) 0 0 0 0 0 0 0 0 0 0
Delirium 1/4 (25.0) 0/2 (0) 0 1/1 (100.0) 0 0/1 (0) 0 0 0 0 0 0 0
Treatment responsel 4/4 (100.0) 0 0 1/1 (100.0) 0 0 0 1/1 (100.0) 0 0 0 0 0
Cognitive decline 0/3 (0) 0 0 0 0 0 0 0 0 0 0 0 0
Quality of life 2/2 (100.0) 0 0 0 0 1/1 (100.0) 1/1 (100.0) 0 0 0 0 0 0
Otherm 5/6 (83.3) 0 1/2 (50.0) 0 0 1/1 (100.0) 1/1 (100.0) 0 0 0 0 0 0
  1. We only stratified by disciplines that have been included in at least 2 articles
  2. N/A not applicable, # number, IQR interquartile range
  3. aMultiple testings for each patient or different testing times for subgroup of patients
  4. bTools that were not developed specifically for measuring frailty
  5. cOperationalized definitions of frailty (for example, ≥65 years of age plus 3 comorbidities)
  6. dClinical Global Impression of Change in Physical Frailty; Geriatrician Clinical Impression of Frailty
  7. eNon-frailty tools that were used only once
  8. fThe Geriatric Evaluation and Management (GEM) drug study criterion was meeting at least 2 of the following 10 criteria: dependence in at least one activity of daily living, stroke within 3 months, previous falls, difficulty ambulating, malnutrition, dementia, depression, unplanned admission in the last 3 months, prolonged bed rest, or incontinence
  9. gArticles that examined the association of a frailty measure with a longitudinal adverse outcome
  10. hInclusion/Exclusions criterion and outcome measure; risk stratification and outcome measure
  11. iArticles which only used frailty as a descriptive characteristic. For example, if an article used frailty both as an inclusion/exclusion criterion and a descriptive characteristic, it was only categorized as inclusion/exclusion criterion in our review
  12. jMore than one outcome can be examined within each article
  13. kFor example, change in anticoagulant use
  14. lFor example, antibody levels
  15. mAdverse outcomes that were examined only once