Association of Hospital Readmissions and Survivability With Frailty and Palliative Performance Scores Among Long-Term Care Residents

Abstract

Background: Frailty and palliative performance scores are 2 markers used in the measurement of functional decline in oncology and hospice care. Objective: To evaluate the frailty and palliative performance scores of a long-term care resident community and determine whether frailty and palliative performance scores can predict hospital readmissions (HR) and survivability of the long-term care resident. Methods: One hundred seventy-one long-term care residents from 2 urban facilities were evaluated for functional decline using the Clinical Frailty Scale (CFS) and Palliative Performance Scale (PPS). Sociodemographic, HR, and survival data for 1 year from study initiation were recorded. Results: The 171 long-term care residents, of lower socioeconomic status, primarily Medicare/Medicaid or dual-eligible, evaluated for functional decline using the CFS and PPS, had mean age of 73.1 years, 52.6% female, 94.7% African American, with 18.1% having HR and 87.1% surviving more than a year. There was a negative association between age and HR ( P = .384). Among functional evaluation scales, CFS was positively associated with age ( P = .013) but not PPS ( P = .673). The residents scored 6.0 ± 1.2 on CFS and 52.8 ± 13.2 on PPS (%) with those residents readmitted to hospital having poorer outcomes. Readmission to hospital and survivability of the long-term care resident were both strongly associated with CFS ( P = .001) and PPS ( P = .001). Conclusion: There is a strong association between the 2 markers used in the measurement of functional decline— Frailty measured by CFS and Palliative Performance Score measured by PPS. Frailty and palliative performance scores can strongly predict HR and survivability of the long-term care resident.