Frailty and length of stay in older adults with blunt injury in a national multicentre prospective cohort study.

Autor: Tan TXZ; Emergency Medicine Residency Program, SingHealth Services, Singapore, Singapore., Nadkarni NV; Centre for Quantitative Medicine, Duke-NUS Graduate Medical School, Singapore, Singapore., Chua WC; Trauma Service, Tan Tock Seng Hospital, Singapore, Singapore., Loo LM; Department of General Surgery, National University Hospital, Singapore, Singapore., Iau PTC; Department of General Surgery, National University Hospital, Singapore, Singapore., Ang ASH; Accident & Emergency, Changi General Hospital, Singapore, Singapore., Goo JTT; Department of General Surgery, Khoo Teck Puat Hospital, Singapore, Singapore., Chan KC; Emergency Medicine Department, Ng Teng Fong General Hospital, Singapore, Singapore., Malhotra R; Health Services and Systems Research, Duke-NUS Graduate Medical School, Singapore, Singapore., Ong MEH; Health Services and Systems Research, Duke-NUS Graduate Medical School, Singapore, Singapore.; Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore., Matchar DB; Health Services and Systems Research, Duke-NUS Graduate Medical School, Singapore, Singapore., Seow DCC; Department of Geriatric Medicine, Singapore General Hospital, Singapore, Singapore., Nguyen HV; School of Pharmacy, Memorial University of Newfoundland, Canada, St. John's, NL, Canada., Ng YS; Department of Rehabilitation Medicine, Singapore General Hospital, Singapore, Singapore., Chan A; Centre for Ageing Research and Education, Duke-NUS Graduate Medical School, Singapore, Singapore., Wong TH; Health Services and Systems Research, Duke-NUS Graduate Medical School, Singapore, Singapore.; Department of General Surgery, Singapore General Hospital, Singapore, Singapore.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2021 Apr 30; Vol. 16 (4), pp. e0250803. Date of Electronic Publication: 2021 Apr 30 (Print Publication: 2021).
DOI: 10.1371/journal.pone.0250803
Abstrakt: Background: Patients suffering moderate or severe injury after low falls have higher readmission and long-term mortality rates compared to patients injured by high-velocity mechanisms such as motor vehicle accidents. We hypothesize that this is due to higher pre-injury frailty in low-fall patients, and present baseline patient and frailty demographics of a prospective cohort of moderate and severely injured older patients. Our second hypothesis was that frailty was associated with longer length of stay (LOS) at index admission.
Methods: This is a prospective, nation-wide, multi-center cohort study of Singaporean residents aged ≥55 years admitted for ≥48 hours after blunt injury with an injury severity score or new injury severity score ≥10, or an Organ Injury Scale ≥3, in public hospitals from 2016-2018. Demographics, mechanism of injury and frailty were recorded and analysed by Chi-square, or Kruskal-Wallis as appropriate.
Results: 218 participants met criteria and survived the index admission. Low fall patients had the highest proportion of frailty (44, 27.3%), followed by higher level fallers (3, 21.4%) and motor vehicle accidents (1, 2.3%) (p < .01). Injury severity, extreme age, and surgery were independently associated with longer LOS. Frail patients were paradoxically noted to have shorter LOS (p < .05).
Conclusion: Patients sustaining moderate or severe injury after low falls are more likely to be frail compared to patients injured after higher-velocity mechanisms. However, this did not translate into longer adjusted LOS in hospital at index admission.
Competing Interests: One or more of the authors are employed by SingHealth Services. This does not alter our adherence to PLOS ONE policies on sharing data and materials. The undersigned authors declare that they have otherwise no financial or personal conflicts of interest to declare.
Databáze: MEDLINE
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