Effectiveness of a Frailty Assessment Index to Predict Early Readmission Rates in Frail and Older Adult Renal Transplant Patients

Background: Renal transplantation is a complex intervention integrating both medical and surgical modalities, and is considered the treatment of choice for many individuals with end-stage renal disease. The complicated care of patients undergoing renal transplantation puts them at risk for adverse outcomes including infection, allograft loss, and a greater risk for some types of cancer. Evaluating patients to ensure they have the ability and support to cope with the stress of surgery and recovery, is an important part of determining the most appropriate candidates to receive the limited supply of organs available. Frailty has increasingly been identified as a predictor of poor surgical outcomes, mortality, and hospital readmissions. A review of literature was conducted to analyze the impact of frailty on renal transplantation outcomes, as well as the usefulness of the 5-Item Modified Frailty Index to predict 30-day readmission rates among renal transplant recipients. Purpose: The project purpose was to evaluate the effectiveness of the 5-Item Modified Frailty Index (mFI-5) to predict 30-day re-admission rates among renal transplant recipients and was accomplished through a retrospective chart review performed at an inpatient hospital transplant institute in Shelby County, Tennessee, and included 194 electronic medical records related to patients who had undergone renal transplantation between December 2020 and December 2021. Results: Data from this retrospective review revealed individuals scoring two or greater on the mFI-5 screening tool, had a significantly higher readmission rate (51.4%) compared to the readmission rate (27.2%) for individuals scoring less than two. Conclusion: The results of this project indicate that mFI-5 does have utility in the evaluation of frailty in renal transplantation patients and warrants further study to determine it’s full application and value