Clinical frailty assessment might be associated with mortality in incident dialysis patients

Introduction: Frailty is associated with mortality in maintenance dialysis patients. We investigated frailty using the clinical frailty scale (CFS) as related to mortality or hospitalization within two years in incident dialysis patients. Methods: We retrospectively reviewed medical records of patients initiating hemodialysis or peritoneal dialysis during 2016–2018. Based on the medical records, two dialysis nurses independently used a 9-point CFS (1 = “Very fit” to 9 = “Terminally ill”) to assess each patient’s frailty at dialysis initiation. Patients with a mean CFS value of 5 or higher were classified as the frailty group. Results: The analysis included 155 incident dialysis patients with mean age of 66.7±14.1 (71% male). Frailty was determined in 43 (28%) patients at dialysis initiation. Kaplan–Meier analyses showed that the survival and hospitalization-free rate within two years was significantly lower in the frailty group than in the non-frailty group ( p < .01). Cox proportional hazards regression analyses revealed the CFS score as associated with the occurrence of a composite outcome, independently of age (hazard ratio 1.34, 95% confidence interval 1.04–1.72). Conclusion: Frailty assessment based on clinical judgment using CFS might predict adverse outcomes in the dialysis-initiated patients.