What does this research mean for the field?

The Hospital Frailty Risk Score (HFRS) independently predicts the risk of one-year hospital readmission in very old patients with heart failure, with higher frailty scores correlating with increased readmission risk. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

April 4, 2026Open Access

Hospital Frailty Risk Score Predicts Long-Term Hospital Readmissions in Very Old Patients with Heart Failure

Key Result

The Hospital Frailty Risk Score predicted 1-year readmission in older heart failure patients, with the middle tertile having a 1.29 increased risk (95% CI 1.03-1.61) versus the lowest.

Key Points

This research aims to assess how frailty, measured by the Hospital Frailty Risk Score, predicts long-term hospital readmission risk in elderly patients with heart failure.
Included older adults hospitalized for heart failure in an acute geriatric ward
Frailty assessed at admission using Hospital Frailty Risk Score (HFRS)
Readmission risk evaluated up to one year post-discharge using Cox regression models
Patients categorized into tertiles based on their HFRS scores
Out of 213 patients, 155 were found to be frail based on HFRS
117 patients were readmitted to the hospital within one year
A significant trend in readmission risk increased across HFRS tertiles, with the middle tertile showing a 1.29 times higher risk than the lowest
Patients in the highest tertile had a similar 1.29 fold increase in readmission risk

Structured PICO

Does a higher Hospital Frailty Risk Score (HFRS) predict an increased risk of long-term hospital readmission in very old patients with heart failure?

Population

213 older adults hospitalized in an acute geriatric ward due to heart failure, mean age 86 ± 7 years, 46% male.

Intervention

Higher Hospital Frailty Risk Score (HFRS) tertiles (middle and highest tertiles) assessed at admission

Comparator

Lowest Hospital Frailty Risk Score (HFRS) tertile

Outcome

Any hospital readmission up to one year after dischargehard clinical

The Hospital Frailty Risk Score (HFRS) is a feasible tool that effectively predicts the one-year risk of hospital readmission in very old patients hospitalized for heart failure.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Background: Heart failure (HF) is a highly prevalent condition among older adults, with a remarkable rate of re-hospitalization due to exacerbations. Frailty is strongly correlated with negative outcomes and might reveal patients in need of tailored follow-up. The aim of the study is to evaluate the predictive role of frailty in long-term re-hospitalization risk. Methods: In this prospective study, older adults hospitalized in an acute geriatric ward due to HF were included. Frailty was assessed at admission time by hospital frailty risk score (HFRS). Any hospital readmission was investigated up to one year after discharge. Patients were divided into tertiles upon receiving their HFRS, and readmission risk was evaluated by Cox regression models. Results: Among 213 patients (mean age 86 ± 7 years, 98, 46% male), 155 were frail according to HFRS. A total of 117 subjects were readmitted to hospital within one year after discharge. A Cox regression model showed that, even after adjustment for multiple selected variables, there was a significant increasing trend in the readmission risk across HFRS tertiles: compared with the lowest tertile, patients in the middle tertile had an risk of readmission of 1.29 (95% C.I.: 1.03–1.61), while those in the highest tertile showed a further 1.29 increase. Conclusions: Among patients with HF, long-term re-hospitalizations might be largely influenced by a previous state of frailty. HFRS is a feasible and broadly applicable tool that could be included in routine clinical practice to promptly identify heart failure patients at higher risk of readmission, in order to plan tailored assistance measures.