Background. Despite the increased prevalence of frailty and the unfavorable implications that follow, the implementation of frailty assessment has yet to be established in clinical practice. The 5-item FRAIL scale is an easy-to-apply tool that showed a good correlation with age, presence of comorbidities, and dialysis complications. This study aimed to identify the association between frailty severity and clinical outcomes, including death and hospitalizations.

Method. A prospective cohort study was conducted in the outpatient dialysis unit of a private tertiary hospital in Cebu, Philippines. Between October 2023 and September 2024, 160 eligible patients on maintenance hemodialysis were evaluated for frailty. Clinicodemographic parameters were retrieved. Comparative analyses were performed using chi-square tests and one-way ANOVA with post hoc analysis. Binary logistic regression analysis was conducted to determine significant associations between outcomes and frailty scores.

Results. The majority of patients were categorized as pre-frail, 53.13% (n=85), with a mean age of 59.28 ± 14.50 years, compared to frail patients (28.13%, n=45), who had a significantly higher mean age of 66.16 ± 14.04 years. Regression analysis demonstrated that heart failure, cancer, and coronary artery disease/ischemic heart disease were significantly associated with frailty.

Conclusion. Mortality significantly increased with frailty severity (3.33% of non-frail, 12.94% of pre-frail, and 40% of frail patients). Among the components of the FRAIL scale, ambulation challenges, illness, and weight loss in CKD patients undergoing hemodialysis were identified to have significant burdens and implicate areas for targeted interventions.

Keywords. FRAIL scale, Frailty, Chronic Kidney Disease, Hemodialysis, mortality, hospitalization

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