Comparing clinician descriptions of frailty and geriatric syndromes using electronic health records: a retrospective cohort study

BMC Geriatrics
Laura J AnzaldiHadi Kharrazi

Abstract

Geriatric syndromes, including frailty, are common in older adults and associated with adverse outcomes. We compared patients described in clinical notes as "frail" to other older adults with respect to geriatric syndrome burden and healthcare utilization. We conducted a retrospective cohort study on 18,341 Medicare Advantage enrollees aged 65+ (members of a large nonprofit medical group in Massachusetts), analyzing up to three years of administrative claims and structured and unstructured electronic health record (EHR) data. We determined the presence of ten geriatric syndromes (falls, malnutrition, dementia, severe urinary control issues, absence of fecal control, visual impairment, walking difficulty, pressure ulcers, lack of social support, and weight loss) from claims and EHR data, and the presence of frailty descriptions in clinical notes with a pattern-matching natural language processing (NLP) algorithm. Of the 18,341 patients, we found that 2202 (12%) were described as "frail" in clinical notes. "Frail" patients were older (82.3 ± 6.8 vs 75.9 ± 5.9, p < .001) and had higher rates of healthcare utilization, including number of inpatient hospitalizations and emergency department visits, than the rest of the population (p...Continue Reading

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Citations

May 29, 2018·Journal of Comparative Effectiveness Research·Kit N SimpsonAnnie N Simpson
Jul 5, 2018·Journal of the American Geriatrics Society·Hadi KharraziJonathan P Weiner
Feb 27, 2020·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Agneta H CalfJan C Ter Maaten
Aug 23, 2018·Aging Clinical and Experimental Research·Rachel C AmbagtsheerElsa Dent
Aug 4, 2020·Annals of Geriatric Medicine and Research·Dae Hyun Kim
Jul 3, 2019·Journal of the American Medical Informatics Association : JAMIA·Tao ChenHadi Kharrazi
Apr 25, 2018·Zeitschrift für Rheumatologie·H-J Lakomek, Christian Schulz
Feb 12, 2020·Age and Ageing·Oliver M ToddAndrew P Clegg
Oct 23, 2020·Arthritis Care & Research·Rand Nashi, Devyani Misra
Jan 2, 2020·Revista española de geriatría y gerontología·Angela AbrahamBhaskar Mandal
Mar 10, 2021·The American Journal of Hospice & Palliative Care·Munther M QueisiMihaela S Stefan
Aug 24, 2020·Archives of Gerontology and Geriatrics·Anand K BeryHadi Kharrazi
Apr 23, 2021·The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences·Robert MiddletonDaniel Prieto-Alhambra
Jul 22, 2021·Revista brasileira de enfermagem·Fabiana Maria Rodrigues Lopes de OliveiraMaria das Graças Melo Fernandes

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