Bibliographic record
Abstract
Background:Guidelines recommend an assessment of frailty early in the course of a surgical plan of care.The Clinical Frailty Scale (CFS) is a validated frailty tool.Its utility in predicting clinical outcomes following hip fracture in older adults is unknown.The primary objective was to determine if the CFS was associated with adverse discharge destination.Secondary objectives were to determine if the CFS was associated with in-hospital complications and length of stay. Methods:We conducted a 5-year retrospective cohort study of patients ≥65 years admitted with an isolated hip fracture.Pre-admission CFS was determined as part of routine clinical care prospectively and abstracted from the chart.We collected demographic and process data associated with adverse outcomes (age, sex, time to surgery, mode of anesthesia) and used multivariable logistic regression to determine the association between CFS and the various outcomes.Results: There were 422 patients.Pre-admission frailty was independently associated with adverse discharge destination (adjusted odds ratio 23.0; 95% CI 3.0 to 173.5) and in-hospital complications (adjusted odds ratio 4.8; 95% CI 2.1 to 10.8) in a greater magnitude than traditional risk factors such as age, male sex, time to surgery and mode of anesthesia.There was a dose-response relationship between increasing frailty and length of stay (p<.001).Discussion: Our study findings are congruent with other hip fracture studies which have demonstrated frailty in predicting increased mortality, length of stay and postoperative complications.Identifying frailty can help risk stratify and guide clinical decision making while increasing patient-centered care.Conclusions: This is the first study to examine use of the CFS in predicting adverse outcomes following hip fracture.Pre-admission frailty as quantified by the CFS is associated with discharge destination, in-hospital complications, and length of stay.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.006 | 0.004 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.004 | 0.001 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.353 | 0.239 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".