LAUSR

BACKGROUND Healthcare associated infections (HAIs) are a major health concern associated with significant morbidity and mortality. The relationship between frailty, a syndrome often associated with older individuals, and HAIs has not been investigated. AIM To determine if frailty scoring systems can assist in predicting the risk of developing HAIs in healthcare settings. METHODS A directed search was conducted across four databases (MEDLINE, Cochrane, Scopus and CINAHL) for articles published between 1 January 1990 and 31 December 2019. All articles were screened for relevance to the research aims. The Newcastle-Ottawa Scale was utilised to assess the study quality and risk of bias. FINDINGS The literature search yielded 290 results, with 14 articles meeting the inclusion criteria. Significant heterogeneity was present across the studies with regards to the frailty index employed and HAI definitions. Most studies were conducted in an acute healthcare setting (n= 12), while two studies were conducted in nursing homes. Eight studies demonstrated that frail individuals were at an increased risk of developing HAIs, in both surgical (n= 5) and medical patient populations (n= 2). Two of the three validated frailty scoring systems employed across the studies, the Clinical Frailty Scale and the Frailty Index demonstrated this relationship. CONCLUSIONS The results of this review demonstrate a potential association between frailty and the development of healthcare associated infections.