Higher Hospital Frailty Risk Score is associated with increased complications and healthcare resource utilization after endovascular treatment of ruptured intracranial aneurysms

Abstract

AimTo use the Hospital Frailty Risk Score (HFRS) to investigate the impact of frailty on complication rates and healthcare resource utilization in patients who underwent endovascular treatment of ruptured intracranial aneurysms (IAs).MethodsA retrospective cohort study was performed using the 2016–2019 National Inpatient Sample database. All adult patients (≥18 years) undergoing endovascular treatment for IAs after subarachnoid hemorrhage were identified using ICD-10-CM codes. Patients were categorized into frailty cohorts: low (HFRS <5), intermediate (HFRS 5–15) and high (HFRS >15). Patient demographics, adverse events, length of stay (LOS), discharge disposition, and total cost of admission were assessed. Multivariate logistic regression analysis was used to identify independent predictors of prolonged LOS, increased cost, and non-routine discharge.ResultsOf the 33 840 patients identified, 7940 (23.5%) were found to be low, 20 075 (59.3%) intermediate and 5825 (17.2%) high frailty by HFRS criteria. The rate of encountering any adverse event was significantly greater in the higher frailty cohorts (low: 59.9%; intermediate: 92.4%; high: 99.2%, p<0.001). There was a stepwise increase in mean LOS (low: 11.7±8.2 days; intermediate: 18.7±14.1 days; high: 26.6±20.1 days, p<0.001), mean total hospital cost (low: $62 888±37 757; intermediate: $99 670±63 446; high: $134 937±80 331, p<0.001), and non-routine discharge (low: 17.3%; intermediate: 44.4%; high: 69.4%, p<0.001) with increasing frailty. On multivariate regression analysis, a similar stepwise impact was found in prolonged LOS (intermediate: OR 2.38, p<0.001; high: OR 4.49, p<0.001)], total hospital cost (intermediate: OR 2.15, p<0.001; high: OR 3.62, p<0.001), and non-routine discharge (intermediate: OR 2.13, p<0.001; high: OR 4.17, p<0.001).ConclusionsOur study found that greater frailty as defined by the HFRS was associated with increased complications, LOS, total costs, and non-routine discharge.

Bioinformatics analysis constructs potential ferroptosis-related ceRNA network involved in the formation of intracranial aneurysm

“…In the Chinese population aged 35–75 years, the prevalence of IA is as high as 7% ( Chen et al, 2018 ). More than 80% of nontraumatic subarachnoid hemorrhages (SAHs) are caused by IA rupture ( Kassell et al, 1990 ; Koo et al, 2022 ). Aneurysmal SAHs have high mortality and disability rates, and are associated with devastating complications, such as delayed cerebral ischemia, seizures, and cerebral vasospasm (CVS), which can lead to poor prognosis and a heavy burden on society ( Chalouhi et al, 2013 ; Chaudhry et al, 2021 ).…”

Higher Hospital Frailty Risk Score Is an Independent Predictor of In-Hospital Mortality in Hospitalized Older Adults with Obstructive Sleep Apnea

“…HFRS was derived from data from more than one million older patients in the United Kingdom [ 27 ]. HFRS has been used for assessing frailty in other disease conditions such as heart failure, ruptured intracranial aneurysms, and hepatocellular carcinoma [ 28 , 29 , 30 ]. Although the Fried frailty phenotype is the most used frailty screening measure, we could not use the Fried frailty phenotype because it requires performing physical tests.…”

Higher Hospital Frailty Risk Score Is Associated With Increased Risk of Stroke: Observational and Genetic Analyses

“…16 HFRS has been showed to predict adverse events across difference conditions. 8,[17][18][19] In recent studies from Kilkenny et al and Pinho et, al. frailty ascertained using HFRS was associated with worse outcomes following stroke/transient ischemic attack.…”