A Pilot Study of the Clinical Frailty Scale to Predict Frailty Transition and Readmission in Older Patients in Vietnam

Background. The Clinical Frailty Scale (CFS) is gaining increasing acceptance due to its simplicity and applicability. Aims. This pilot study aims to examine the role of CFS in identifying the prevalence of frailty, frailty transition, and the impact of frailty on readmission after discharge in older hospitalized patients. Methods. Patients aged >= 60 admitted to the geriatric ward of a hospital in Vietnam were recruited from 9/2018-3/2019 and followed for three months. Frailty was assessed before discharge and after three months, using the CFS (robust: score 1-2, pre-frail: 3-4, and frail: >= 5). Multivariate logistic regression was applied to investigate the associated factors of frailty transition and the impact of frailty on readmission. Results. There were 364 participants, mean age 74.9, 58.2% female. At discharge, 4 were robust, 160 pre-frail, 200 frail. Among the 160 pre-frail participants at discharge, 124 (77.5%) remained pre-frail, and 36 (22.5%) became frail after 3 months. Age (adjusted OR1.09, 95% CI 1.03-1.16), number of chronic diseases (adjusted OR 1.37, 95% CI 1.03-1.82), and polypharmacy at discharge (adjusted OR 3.68, 95% CI 1.15-11.76) were significant predictors for frailty after 3 months. A frailty status at discharge was significantly associated with increased risk of readmission (adjusted OR2.87, 95% CI 1.71-4.82). Conclusions. Frailty was present in half of the participants and associated with increased risk of readmission. This study suggests further studies to explore the use of the CFS via phone calls for monitoring patients' frailty status after discharge, which may be helpful for older patients living in rural and remote areas.