Association of a modified laboratory frailty index with adverse outcomes in geriatric rehabilitation inpatients: RESORT

Highlights

• Frailty is highly prevalent in geriatric rehabilitation inpatients.

• A higher modified frailty index based on lab tests was associated with mortality.

• More lab tests regardless of the results were associated with institutionalization.

• The number of lab tests should be integrated in frailty tools.

• The clinical frailty index is better than the mFI-Lab predicting adverse outcomes.

Abstract

A higher number of laboratory measurements is associated with mortality in patients admitted to hospital, but is not part of the frailty index based on laboratory tests (FILab). This study aimed to modify the FI-Lab (mFI-Lab) by accounting for the number of laboratory measurements and compare its validity to predict institutionalization and mortality at three-month post-discharge with the clinical frailty scale (CFS) in geriatric rehabilitation inpatients. In 1819 patients (median age 83.3 [77.6–88.3], 56.6% female), a higher FI-Lab was not associated with institutionalization but a higher risk of mortality. A higher mFI-Lab was associated with lower odds of institutionalization but a higher risk of mortality. A higher CFS was associated with institutionalization and higher mortality. The Akaike information criterion value was lowest for the CFS, followed by the mFI-Lab and the FI-Lab. The CFS is better than the mFI-Lab predicting short-term adverse outcomes in geriatric rehabilitation inpatients. When using laboratory data to estimate frailty, the mFI-Lab rather than the FI-Lab should be used.