Association between frailty, as measured by the FRAIL scale, and 1-year mortality in older patients undergoing hip fracture surgery
Abstract Background The FRAIL scale is a concise and user-friendly tool for frailty assessment. However, its effectiveness in predicting 1-year mortality among older patients undergoing hip fracture surgery remains unclear. This study explored the relationship between preoperative frailty, as measur...
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BMC
2025-01-01
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| Series: | BMC Geriatrics |
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| Online Access: | https://doi.org/10.1186/s12877-025-05716-z |
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| author | Shaohua Xi Zhibin Wu Jian Cui Suran Yin Shaozhi Xi Chaoyang Liu |
| author_facet | Shaohua Xi Zhibin Wu Jian Cui Suran Yin Shaozhi Xi Chaoyang Liu |
| author_sort | Shaohua Xi |
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| description | Abstract Background The FRAIL scale is a concise and user-friendly tool for frailty assessment. However, its effectiveness in predicting 1-year mortality among older patients undergoing hip fracture surgery remains unclear. This study explored the relationship between preoperative frailty, as measured by the FRAIL scale, and 1-year mortality after surgery in this population. Methods This retrospective analysis included 194 older patients (aged ≥ 75 years) with hip fractures who underwent surgical treatment in our departments from January 2019 to December 2022. Perioperative clinical data were collected, and all-cause mortality within 1 year after surgery was monitored. Patients were categorized into non-frail (n = 114) and frail (n = 80) groups based on their FRAIL scores. Postoperative complications and 1-year mortality rates were compared between these groups. The association of preoperative frailty with 1-year mortality and its predictive capability were assessed. Results Among the 194 older hip fracture patients, 78 (40.2%) were male, with a mean (standard deviation [SD]) age of 84.4 (6.3) years. The overall incidence of 1-year mortality after surgery was 11.3% (22/194). Frail patients had a higher incidence of Clavien-Dindo (CD) classification of surgical complications ≥ II (31.3% vs. 12.3%, p = 0.00) and greater 1-year mortality (21.3% vs. 4.4%, p = 0.00) compared with non-frail patients. Cox regression analysis indicated that preoperative frailty was independently associated with 1-year mortality (adjusted hazard ratio: 3.88; 95% confidence interval [CI]: 1.28–11.77; p = 0.02). The FRAIL scale demonstrated acceptable discriminatory capacity for predicting 1-year mortality in these patients (area under the curve: 0.70; 95% CI: 0.59–0.81). Conclusions Frailty, as measured by the FRAIL scale, was independently associated with 1-year mortality in older patients undergoing hip fracture surgery. The scale can be used to stratify risk and facilitate personalized perioperative treatment and management. |
| format | Article |
| id | doaj-art-eb8dd340e2924f8b9db8b5b546fc7469 |
| institution | Kabale University |
| issn | 1471-2318 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | BMC Geriatrics |
| spelling | doaj-art-eb8dd340e2924f8b9db8b5b546fc74692025-02-02T12:41:50ZengBMCBMC Geriatrics1471-23182025-01-012511710.1186/s12877-025-05716-zAssociation between frailty, as measured by the FRAIL scale, and 1-year mortality in older patients undergoing hip fracture surgeryShaohua Xi0Zhibin Wu1Jian Cui2Suran Yin3Shaozhi Xi4Chaoyang Liu5Second Department of Orthopaedics, The Second Affiliated Hospital of Xingtai Medical CollegeDepartment of Cardiology, The Second Affiliated Hospital of Xingtai Medical CollegeDepartment of Anesthesiology, The Second Affiliated Hospital of Xingtai Medical CollegeSecond Department of Orthopaedics, The Second Affiliated Hospital of Xingtai Medical CollegeDepartment of Comprehensive Surgery, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General HospitalDepartment of Comprehensive Surgery, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General HospitalAbstract Background The FRAIL scale is a concise and user-friendly tool for frailty assessment. However, its effectiveness in predicting 1-year mortality among older patients undergoing hip fracture surgery remains unclear. This study explored the relationship between preoperative frailty, as measured by the FRAIL scale, and 1-year mortality after surgery in this population. Methods This retrospective analysis included 194 older patients (aged ≥ 75 years) with hip fractures who underwent surgical treatment in our departments from January 2019 to December 2022. Perioperative clinical data were collected, and all-cause mortality within 1 year after surgery was monitored. Patients were categorized into non-frail (n = 114) and frail (n = 80) groups based on their FRAIL scores. Postoperative complications and 1-year mortality rates were compared between these groups. The association of preoperative frailty with 1-year mortality and its predictive capability were assessed. Results Among the 194 older hip fracture patients, 78 (40.2%) were male, with a mean (standard deviation [SD]) age of 84.4 (6.3) years. The overall incidence of 1-year mortality after surgery was 11.3% (22/194). Frail patients had a higher incidence of Clavien-Dindo (CD) classification of surgical complications ≥ II (31.3% vs. 12.3%, p = 0.00) and greater 1-year mortality (21.3% vs. 4.4%, p = 0.00) compared with non-frail patients. Cox regression analysis indicated that preoperative frailty was independently associated with 1-year mortality (adjusted hazard ratio: 3.88; 95% confidence interval [CI]: 1.28–11.77; p = 0.02). The FRAIL scale demonstrated acceptable discriminatory capacity for predicting 1-year mortality in these patients (area under the curve: 0.70; 95% CI: 0.59–0.81). Conclusions Frailty, as measured by the FRAIL scale, was independently associated with 1-year mortality in older patients undergoing hip fracture surgery. The scale can be used to stratify risk and facilitate personalized perioperative treatment and management.https://doi.org/10.1186/s12877-025-05716-zOlder adultsHip fractureFrailtyAll-cause mortality |
| spellingShingle | Shaohua Xi Zhibin Wu Jian Cui Suran Yin Shaozhi Xi Chaoyang Liu Association between frailty, as measured by the FRAIL scale, and 1-year mortality in older patients undergoing hip fracture surgery BMC Geriatrics Older adults Hip fracture Frailty All-cause mortality |
| title | Association between frailty, as measured by the FRAIL scale, and 1-year mortality in older patients undergoing hip fracture surgery |
| title_full | Association between frailty, as measured by the FRAIL scale, and 1-year mortality in older patients undergoing hip fracture surgery |
| title_fullStr | Association between frailty, as measured by the FRAIL scale, and 1-year mortality in older patients undergoing hip fracture surgery |
| title_full_unstemmed | Association between frailty, as measured by the FRAIL scale, and 1-year mortality in older patients undergoing hip fracture surgery |
| title_short | Association between frailty, as measured by the FRAIL scale, and 1-year mortality in older patients undergoing hip fracture surgery |
| title_sort | association between frailty as measured by the frail scale and 1 year mortality in older patients undergoing hip fracture surgery |
| topic | Older adults Hip fracture Frailty All-cause mortality |
| url | https://doi.org/10.1186/s12877-025-05716-z |
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