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

NCT07529470 | Completed

• 1 other identifier: 2024-0459-1
• Study Type: observational
• Target: 2,610
• Locations: 1 country
• Sites: 1

Brief 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.

Conditions

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

Keywords

Hospital at home; Frailty; Survival; Complex Chronic Patients; Rockwood Index

Outcome Measures

Primary Outcomes (1)

• Overall Survival

  Time from discharge from the Hospital-at-Home unit to death from any cause.

  1 year

Secondary Outcomes (7)

• Comparative prognostic performance of the Rockwood Frailty Index versus Charlson Comorbidity Index

  1 year

• Association between age and overall survival

  1 year

• Association between sex and overall survival

  1 year

• Association between overall survival and clinical variables (Charlson Comorbidity Index)

  1 year

• Association between overall survival and clinical variables (Barthel Index)

  1 year

Study Arms (1)

Older adults with complex chronic diseases or palliative care needs

All patients must 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.

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

Interventions

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 OTHER

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.

Older adults with complex chronic diseases or palliative care needs

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients aged over 65 years with a high comorbidity burden and functional dependence, and/or with advanced cancer requiring symptom management and end-of-life care.

You may qualify if:

• Age ≥65 years
• Admission to the Hospital-at-Home unit during the study period
• Recorded modified Rockwood Frailty Index at admission
• Participation in the post-discharge case management follow-up program

You may not qualify if:

• Incomplete data for frailty index calculation
• Immediate loss to follow-up after discharge

Sponsors & Collaborators

• Instituto de Investigacion Sanitaria La Fe: lead

Study Sites (1)

Hospital Universitari i Politècnic La Fe

Valencia, Valencia, 46026, Spain

Location

Related Publications (7)

• Hall A, Boulton E, Kunonga P, Spiers G, Beyer F, Bower P, Craig D, Todd C, Hanratty B. Identifying older adults with frailty approaching end-of-life: A systematic review. Palliat Med. 2021 Dec;35(10):1832-1843. doi: 10.1177/02692163211045917. Epub 2021 Sep 14.

  PMID: 34519246 BACKGROUND

• Kojima G, Iliffe S, Walters K. Frailty index as a predictor of mortality: a systematic review and meta-analysis. Age Ageing. 2018 Mar 1;47(2):193-200. doi: 10.1093/ageing/afx162.

  PMID: 29040347 BACKGROUND

• Ko W, Jeong H, Yim HW. Frailty Index Predicts Future All-cause Mortality and Quality of Life: A 2-Year Follow-up Study Among Korean Older Adults From a Population-based Cohort Study. J Prev Med Public Health. 2025 Nov;58(6):572-580. doi: 10.3961/jpmph.25.210. Epub 2025 Nov 10.

  PMID: 41223731 BACKGROUND

• Salminen M, Viljanen A, Eloranta S, Viikari P, Wuorela M, Vahlberg T, Isoaho R, Kivela SL, Korhonen P, Irjala K, Lopponen M, Viikari L. Frailty and mortality: an 18-year follow-up study among Finnish community-dwelling older people. Aging Clin Exp Res. 2020 Oct;32(10):2013-2019. doi: 10.1007/s40520-019-01383-4. Epub 2019 Oct 25.

  PMID: 31654244 BACKGROUND

• Amblas-Novellas J, Martori JC, Molist Brunet N, Oller R, Gomez-Batiste X, Espaulella Panicot J. [Frail-VIG index: Design and evaluation of a new frailty index based on the Comprehensive Geriatric Assessment]. Rev Esp Geriatr Gerontol. 2017 May-Jun;52(3):119-127. doi: 10.1016/j.regg.2016.09.003. Epub 2016 Oct 28. Spanish.

  PMID: 28029467 BACKGROUND

• Martinez-Velilla N, Herce PA, Herrero AC, Gutierrez-Valencia M, Saez de Asteasu ML, Mateos AS, Zubillaga AC, Beroiz BI, Jimenez AG, Izquierdo M. Heterogeneity of Different Tools for Detecting the Prevalence of Frailty in Nursing Homes: Feasibility and Meaning of Different Approaches. J Am Med Dir Assoc. 2017 Oct 1;18(10):898.e1-898.e8. doi: 10.1016/j.jamda.2017.06.016. Epub 2017 Jul 27.

  PMID: 28757333 BACKGROUND

• Rockwood K, Song X, MacKnight C, Bergman H, Hogan DB, McDowell I, Mitnitski A. A global clinical measure of fitness and frailty in elderly people. CMAJ. 2005 Aug 30;173(5):489-95. doi: 10.1503/cmaj.050051.

  PMID: 16129869 BACKGROUND

MeSH Terms

Conditions

Frailty

Condition Hierarchy (Ancestors)

Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Vicente Ruiz Garcia, MD, PhD

  Hospital at Home Unit - Hospital UiP La Fe Valencia Avda Fernando Abril Martorell 106 Torre B Planta 1 Valencia 26206 (SPAIN)

  PRINCIPAL INVESTIGATOR

• Elisa Soriano Melchor, MD, PhD

  Hospital at Home Unit - Hospital UiP La Fe Valencia Avda Fernando Abril Martorell 106 Torre B Planta 1 Valencia 26206 (SPAIN)

  STUDY CHAIR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: April 8, 2026
• First Posted: April 14, 2026
• Study Start: January 1, 2021
• Primary Completion: December 31, 2024
• Study Completion: December 31, 2024
• Last Updated: April 21, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, CSR
• Time Frame: Starting after publication of the study results; duration of availability will be determined according to institutional policies.
• Access Criteria: Qualified researchers who submit a reasonable research proposal will be able to access the de-identified individual participant data (IPD) and supporting documentation (such as the data dictionary). Access will be granted after review and approval by the study investigators and the corresponding institution. Data will be provided in a de-identified format and shared through secure data transfer methods. Researchers may be required to sign a data use agreement to ensure compliance with ethical standards, data protection regulations, and intended use of the data.

Locations

ES (1)