Frailty assessment scores may predict length of stay and complications

Dec. 18, 2020 / By L. Gordon Moore, MD

With all of the data we have on diagnosis, comorbidity, age and sex, we still only access a small subset of factors that predict a person’s likelihood of experiencing complications and increased length of stay for any particular procedure. 

We know, for instance, that the probability of emergency room visits for people with asthma increases with the severity of asthma.  Table 1 below uses the 3M Clinical Risk Groups (CRGs) methodology to sort 1,040 people with asthma into severity levels, noting the expected rate of inpatient or emergency room use per severity cohort in a 12-month period.

Table 1

When we consider the impact of co-morbidity on a condition, we know even more about the likelihood of a person with diabetes ending up in the hospital in a 12-month period. The table below from Bernstein’s study of people with diabetes in a commercial population is an example.

A colleague of mine—Dr. Victoria Sharp—has been exploring tools that score people on a frailty index.  In a conversation recorded for the Inside Angle podcast, she describes frailty tools that score medical patients so that care teams can bring appropriate resources to bear. She also describes others used pre-operatively that might guide a discussion regarding the risk of a procedure as well as indicate length of stay and complication rates.

Knowing more about a person helps us better understand risk and consider interventions to mitigate risk.  Knowing more adds to the volume of data capture and methodologies that help us make sense of all of the data. Come listen to Dr. Sharp describe her exploration of frailty on the Inside Angle podcast.

L. Gordon Moore, MD, is senior medical director, Clinical Strategy and Value-based Care for 3M Health Information Systems.