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Correspondence on “Higher hospital frailty risk score is associated with increased complications and healthcare resource utilization after endovascular treatment of ruptured intracranial aneurysms” by Koo et al
  1. Emily Estes1,
  2. Kavelin Rumalla2,
  3. Meic H Schmidt2,
  4. Christian Bowers2
  1. 1 Neurosurgery, TTUHSC El Paso Foster School of Medicine, El Paso, Texas, USA
  2. 2 Neurosurgery, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA
  1. Correspondence to Dr Christian Bowers, University of New Mexico Health Sciences Center, Albuquerque, NM 81731, USA; CABowers{at}

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We read with great interest the recently published article by Koo et al.1 This retrospective cohort study used the Hospital Frailty Risk Score (HFRS) to measure ‘frailty’ and its association with complication rates and healthcare resource utilization in patients who underwent endovascular treatment of ruptured intracranial aneurysms. Koo et al used ICD-10-CM codes to identify patients, who were then categorized into frailty groups: low (HFRS <5), intermediate (HFRS 5–15), and high (HFRS >15). The study concluded that greater frailty, as defined by the HFRS, was associated with increased postoperative complications, length of hospital stay, total healthcare cost, and non-routine discharge disposition. We would appreciate clarification from the authors regarding the following concerns.

The HFRS is a risk score derived from >1000 ICD-10-CM codes over-represented in a population of hospitalized older adults (≥75 years of age).2 One of the most concerning aspects …

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  • Contributors All authors (EE, KR, MHS, CB) contributed significantly to the design, conception, preparation, and review of the letter.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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