Hospital frailty risk score predicts graft failure severe infection and mortality in hospitalized kidney transplant recipients from 2010 to 2018 US data

Frailty is frequently assessed in elderly patients as an indicator of poor outcomes after hospitalization and surgery. Compared to age-matched nonfrail people, frail people need greater assistance with everyday activities and are more likely to suffer adverse events leading to mortality. Recently, the hospital frailty risk score (HFRS) was proposed for quantifying frailty. The number of older people with end-stage renal disease (ESRD) is continuing to increase, and more data have shown that frailty could predict adverse outcomes in kidney transplantation (KT) patients. Moreover, the pre-kidney transplantation HFRS was strongly associated with surgical complications and other adverse and postoperative outcomes. However, it is yet unknown how frailty affects transplant failure prognosis, inpatient mortality and morbidity, and infection. In this retrospective observational study, we extracted data on 185,742 patients from the National Inpatient Sample (NIS) database in the United States. The patients were further separated into three groups based on the HFRS. The study revealed that 24.6% of admitted patients who underwent KT were frail (HFRS > = 5). HFRS stratification can be used to predict the risk of in-hospital mortality, longer LOS, graft failure, and adverse discharge. Furthermore, frail patients who undergo KT are more likely to develop severe infection according to the HFRS-defined frailty classification. According to these findings, frailty remains a severe problem after KT, and patients who undergo KT should be monitored to prevent adverse effects.