# National Norms for Hospital Frailty Risk Score Among Hospitalized Adults in the USA

## TL;DR

This study establishes national norms for a hospital frailty risk score in the USA, showing how frailty risk varies with age, sex, and race.

## Contribution

The study provides the first national normative values for the Hospital Frailty Risk Score (HFRS) stratified by age, sex, and race.

## Key findings

- Frailty risk increases significantly with age across all sexes and races.
- Black and Asian/Pacific Islander inpatients aged 90+ show the highest frailty risk.
- National HFRS norms can serve as a reference for clinical and research comparisons.

## Abstract

Frailty among inpatients increases risk for hospital-associated disability and death. Yet, frailty is not regularly screened in acute care due to the lack of standardized methods, the complexity of frailty, and time and energy required of hospital personnel. Thus, screening with routinely collected data provides an opportunity to assess frailty across inpatient populations.

To calculate normative values for Hospital Frailty Risk Score (HFRS) among adult inpatients in the USA based on age, sex, and race.

A retrospective cross-sectional analysis of the 2018 National Inpatient Sample (NIS) database.

US adult inpatients aged 18y + with a focus on patients aged at least 45.

Hospital Frailty Risk Score (HFRS) is a validated measure that uses ICD-10 codes to calculate frailty risk among hospitalized patients.

Mean HFRS significantly increased with increasing age across sex and race (p < 0.001). Among the oldest age groups 65y + , mean and median normative values were similar between male and female inpatients (mean HFRS range, 6.71–9.62; median HFRS range, 5.40–8.70), and Black inpatients had the highest frailty risk compared to other races (mean HFRS range = 7.56–10.47; median HFRS range = 6.30–9.50). Asian/Pacific Islander inpatients had similar frailty risk to Black inpatients among those 90y + (mean HFRS = 10.48; median HFRS = 9.50).

The US national norms for HFRS provide a standardized reference tool for comparing frailty risk among clinical and research inpatient populations to a typical hospitalized adult for their age, sex, and race.