• Muni Rubens, Anshul Saxena, Venkataraghavan Ramamoorthy, Sandeep Appunni, Md Ashfaq Ahmed, Zhenwei Zhang, Yanjia Zhang, Rehan Sha, and Samer Fahmy.
• the Center for Advanced Analytics, Baptist Health South Florida, Miami.
• South. Med. J. 2024 Nov 1; 117 (11): 646650646-650.

ObjectivesFrail patients are at greater risk of experiencing adverse clinical outcomes in any critical illness due to decreased physiologic reserves, greater susceptibility to the adverse effects of treatment, and greater needs for intensive care. In this study, we sought to assess the prevalence of frailty and associated adverse in-hospital outcomes among coronavirus disease 2019 (COVID-19) hospitalizations using the 2020 California State Inpatient Database (SID).MethodsFor this study, we conducted a retrospective analysis of data from all COVID-19 hospital patients aged 18 years and older. We identified hospitalizations that were at high risk of frailty using the Hospital Frailty Risk Score. The primary outcome of our study was in-hospital mortality, and the secondary outcomes were prolonged length of stay, vasopressor use, mechanical ventilation, and intensive care unit admission.ResultsThe prevalence of frailty was 44.3% among COVID-19 hospitalizations. Using propensity score matching analysis, we found that the odds of mortality (odds ratio [OR] 4.54, 95% confidence interval [CI] 4.28-4.82), prolonged length of stay (OR 2.81, 95% CI 2.70-2.90), vasopressor use (OR 8.65, 95% CI 7.45-10.03), mechanical ventilation (OR 6.90, 95% CI 6.47-7.35), and intensive care unit admission (OR 7.17, 95% CI 6.71-7.66) were significantly higher among the group of frail patients.ConclusionOur findings show that frailty could be used for assessing and risk stratifying patients for improved hospital outcomes.

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