Abstract
Background: This study assessed the role of frailty assessment in the AMU.
Methods: Patients were assessed for frailty and their outcomes ascertained at 90 days.
Results: The Canadian Study on Health and Aging Clinical Frailty Scale categorised 29% of patients as moderately-severely frail. Frailty did not differentially identify those likely to be discharged within one day, nor with long stays. Mortality at 90 days was 32%; frailty was associated with the risk of dying, odds ratio 1.4. 21% of patients were readmitted at 30 days, and 33% at 90 days, but frailty was not predictive.
Discussion: Moderate-severe frailty in people aged 70+ was common and was predictive of higher mortality, but did not appear to predict admission, length of stay or readmission.
[download-attachments container="div" style="list" display_icon="1" display_count="1" display__size="0"]
References
- Percival F, Day N, Lambourne A, et al. An Evaluation of Consultant Input into Acute Medical Admissions Management in England, Wales and Northern Ireland. London: Royal College of Physicians, 2010.
- Woodard J, Gladman J, Conroy S. Frail older people at the interface. Age Ageing 2010; 39(S1): i36.
- Graf CE, Giannelli SV, Herrmann FR, et al. Can We Improve the Detection of Old Patients at Higher Risk for Readmission After An Emergency Department Visit? Journal of the American Geriatrics Society 2012; 60(7): 1372-73.
- Kansagara D, Englander H, Salanitro A. Risk prediction models for hospital readmission: A systematic review. JAMA: The Journal of the American Medical Association 2011; 306(15): 1688-98.
- Cotter PE, Bhalla VK, Wallis SJ, et al. Predicting readmissions: poor performance of the LACE index in an older UK population. Age Ageing 2012; 41(6): 784-9.
- Fried LP, Hadley EC, Walston JD, et al. From bedside to bench: research agenda for frailty.[erratum appears in Sci Aging Knowledge Environ. 2005; 2005(41):er3 Note: Newman, Anne [corrected to Newman, Anne B]]. Science of Aging Knowledge Environment 2005; 2005(31): pe24.
- Rothman MD, Leo-Summers L, Gill TM. Prognostic significance of potential frailty criteria. Journal of the American Geriatrics Society 2008; 56(12): 2211-16.
- Rockwood K, Mitnitski A. Frailty in relation to the accumulation of deficits. Journals of Gerontology Series A-Biological Sciences & Medical Sciences 2007; 62(7): 722-7.
- Rockwood K, Song X, MacKnight C, et al. A global clinical measure of fitness and frailty in elderly people.[see comment]. CMAJ Canadian Medical Association Journal 2005; 173(5): 489-95.
- Hosmer D, Lemeshow D, editors. Applied Logistic Regression. Second Edition ed: John Wiley & sons, 2002.
- Cook NR. Use and Misuse of the Receiver Operating Characteristic Curve in Risk Prediction. Circulation 2007; 115(7):928-35
Request Permissions
To request copyright permission to republish or share portions of our works, please visit Copyright Clearance Center’s (CCC) Marketplace website by clicking the button below:
