NCT07529470

Rockwood Frailty Index and Survival in Hospital-at-Home Patients

Assessment of One-year Mortality Risk Using the Modified 34-item Rockwood Index

• Status: Completed
• Phase: —
• Study type: Observational
• Enrollment: 2,610 (actual)
• Sponsor: Instituto de Investigacion Sanitaria La Fe · Academic / Other
• Sex: All
• Age: 65 Years
• Healthy volunteers: Not accepted

Summary

Frailty is a key determinant of prognosis in older adults with complex chronic conditions and in palliative care settings. The Rockwood Frailty Index (RFI), based on the accumulation of health deficits, has demonstrated prognostic value across multiple clinical contexts. This study evaluates the association between the RFI and overall survival in complex chronic and palliative patients (oncologic and non-oncologic) treated in a Hospital-at-Home (HaH) unit.

Detailed description

This retrospective longitudinal observational cohort study included patients aged 65 years or older admitted to a Hospital-at-Home (HaH) unit between January 1, 2021 and December 31, 2024. All patients had a recorded modified Rockwood Frailty Index (RFI) at admission and were subsequently followed through a structured case-management program led by nurse case managers via scheduled telephone follow-up. Patients were classified into three clinical groups: complex chronic patients, non-oncologic palliative patients, and oncologic palliative patients. Non-oncologic palliative status was defined by an RFI ≥0.53, while complex chronic patients had an RFI \>0.37 and \<0.53. Oncologic palliative patients were classified based on referral from Oncology services regardless of frailty level. The primary outcome was overall survival, defined as time from discharge from the HaH unit to death from any cause. Survival analyses were conducted using Kaplan-Meier curves and multivariate Cox proportional hazards regression models adjusted for relevant demographic, clinical, and laboratory covariates.

Conditions

• Home Care Services, Hospital-Based
• Frailty
• Mortality
• Palliative Care

Interventions

Type	Name	Description
OTHER	Patients identified and followed in this cohort received scheduled supportive telephone calls every two weeks if classified in the oncologic palliative care group, and once monthly in the case of comp	Patients in this cohort received scheduled supportive telephone calls every two weeks if classified under palliative care (oncologic or chronic conditions), and once monthly if classified as chronic non-palliative patients.

Timeline

• Start date: 2021-01-01
• Primary completion: 2024-12-31
• Completion: 2024-12-31
• First posted: 2026-04-14
• Last updated: 2026-04-14

Locations

1 site across 1 country: Spain