Frailty shows enhanced predictive capacity for 1-year unplanned readmission comparing to reason for admission

Abstract Background Frailty, a prevalent geriatric syndrome, predisposes older adults to adverse outcomes including disability and premature mortality. Unplanned hospital readmissions impose substantial economic burdens on families and challenge healthcare systems. Objective To investigate the impact of frailty on 1-year unplanned readmissions among elderly inpatients and further analyze its predictive utility across subgroups stratified by admission causes (acute vs. chronic conditions). Methods This prospective cohort study enrolled patients aged ≥65 years from the Geriatrics Department of Beijing Friendship Hospital, Capital Medical University. Frailty status was assessed using the FRAIL scale, categorizing participants into non-frail and frail groups. Participants were stratified by admission diagnosis (acute/chronic conditions). Baseline demographics, medical histories, and laboratory parameters were collected. Electronic medical records were reviewed to identify unplanned readmissions within 1 year. Results Among 414 enrolled patients. Median age was 82 years (IQR 72∼88), 58.9% (n = 244) were frail. During the 1-year follow-up period, 173 patients (42.8%) experienced unplanned readmissions. Frailty independently predicted 1-year unplanned readmissions (OR = 1.694, 95% CI:1.013–2.830, P = 0.044), with a significant interaction between frailty and admission cause (P for interction 0.006). Subgroup analysis revealed enhanced predictive accuracy of frailty comparing to chronic disease-related admissions. Conclusions Frailty serves as an independent risk factor for 1-year unplanned readmissions in elderly inpatients, particularly among those hospitalized for chronic conditions. Systematic frailty screening at admission coupled with tailored physical rehabilitation programs may mitigate readmission risks.