A meta-analysis of 57 cohort studies quantified what frailty means for a hospitalised older adult's trajectory.
Frailty was associated with worse activities of daily living (standardised mean difference -1.04), more than double the mortality (relative risk 2.26, 95% CI 1.86–2.76), lower chance of being discharged home (RR 0.79), and higher 30-day (RR 1.47) and 90-day readmission (RR 1.75). Heterogeneity was substantial, so the exact sizes are soft, but the direction is consistent across every outcome.
The practical implication is that a frailty score on admission is not paperwork — it identifies the patients who need early functional assessment, a discharge plan started on day one, and realistic conversations about goals. Use it to target rehabilitation, social work and family discussion at the people most likely to lose their independence, rather than discovering the risk at the point of a failed discharge.
- Frailty more than doubled inpatient mortality (RR 2.26)
- Lower chance of home discharge (RR 0.79); higher 30- and 90-day readmission
- Worse activities of daily living (SMD -1.04)
- Use an admission frailty score to trigger early rehab, discharge planning and goal-setting
The statistics, in plain English
A relative risk of 2.26 for mortality means frail patients died at more than twice the rate of non-frail ones; the interval (1.86–2.76) stays well above 1.0. Substantial heterogeneity means the studies varied in how they defined frailty and which patients they enrolled, so treat the doubling as a robust signal and the precise numbers as approximate.
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