Frailty Impact on In-Hospital Outcomes Among Patients Hospitalized with Acute Pulmonary Embolism: A National Inpatient Sample Analysis

Background/Objectives: Acute pulmonary embolism (PE) can be life-threatening, and outcomes vary considerably between patients. Frailty reflects reduced physiologic reserve and may help describe vulnerability during an acute illness. We examined the association between the Hospital Frailty Risk Score (HFRS) and in-hospital outcomes among adults admitted with acute PE.

Methods

We analyzed adult hospitalizations for acute PE recorded in the U.S. National Inpatient Sample between 2016 and 2021. HFRS was reconstructed from 109 three-character ICD-10 categories, with each category counted once per hospitalization and grouped as low (<5), intermediate (5–15), or high (>15). Survey-weighted logistic regression used NIS discharge weights, year-specific strata, and year-specific hospital clusters. Additional analyses were limited to patients aged ≥65 and ≥75 years, adjusted for available PE-severity markers and repeated with a modified HFRS that excluded potentially acute components.