Background The impact of the Hospital Frailty Risk Score on outcomes in hospitalized bladder cancer patients is not studied. This study aims to investigate the association between frailty and bladder cancer outcomes.
Methods Retrospective analysis used National Inpatient Sample data (January 2020 to December 2020) for patients with bladder cancer diagnoses (ICD10-CM codes C67.0-C67.9, D09.0). Hospital frailty score was calculated using ICD-10 index and comorbidities distribution of frailty score suggested in a study published by Gilbert et al.1 Multivariate analysis assessed frailty correlation, stratifying by sex, race, age, Charlson index, median annual income, hospital bed size, teaching status, and census division.
Results Among 8,247 bladder cancer hospitalizations, 81.9% had intermediate to high frailty scores (IHFS) and 18.1% had low frailty scores (LFS). IHFS group had higher unadjusted in-hospital mortality (6.87% vs. 2.48%). IHFS patients had increased adjusted mortality odds (aOR=2.56, 95% CI [1.80–3.62], p=0.000). Adjusted mortality rate had no significant difference between males and females (aOR=0.17, 95% CI [-0.11 - 0.46], p=0.229). Black race patients had higher adjusted mortality odds than Caucasian race patients (aOR=1.69, 95% CI [1.17–2.42], p=0.005). IHFS group also had longer lengths of stay (aOR=2.27 days, 95% CI [2.02 - 2.53], p=0.000) and higher adjusted costs (aOR=$10,410.39, 95% CI [6,403.38 - 14,417.40], p=0.000) compared to the LFS group (table 1).
Conclusions High hospital frailty risk scores in bladder cancer patients are associated with increased mortality rates, prolonged hospital stays, and higher adjusted costs. Assessing frailty aids in predicting outcomes and allows physicians to stratify patients based on risk levels for better management.
Gilbert T, Neuburger J, Kraindler J, Keeble E, Smith P, Ariti C, Arora S, Street A, Parker S, Roberts HC, Bardsley M. Development and validation of a Hospital Frailty Risk Score focusing on older people in acute care settings using electronic hospital records: an observational study. The Lancet. 2018 May 5;391(10132):1775–82.
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