Frailty and mortality: Utility of Frail-VIG index in ED short-stay units for older adults.

Autor: Blázquez-Andión M; Autonomous University of Barcelona, Medicine Department. Plaza Cívica, Bellaterra, Cerdanyola del Valles 08193, Spain.; Emergency Department, Hospital de la Santa Creu i Sant Pau. Sant Quinti 87, Barcelona 08025, Spain; IB Sant Pau, Research Institute. Sant Quinti 91, Barcelona 08025, Spain., Montiel-Dacosta JA; Autonomous University of Barcelona, Medicine Department. Plaza Cívica, Bellaterra, Cerdanyola del Valles 08193, Spain.; Emergency Department, Hospital de la Santa Creu i Sant Pau. Sant Quinti 87, Barcelona 08025, Spain; IB Sant Pau, Research Institute. Sant Quinti 91, Barcelona 08025, Spain., Rizzi-Bordigoni M; Autonomous University of Barcelona, Medicine Department. Plaza Cívica, Bellaterra, Cerdanyola del Valles 08193, Spain.; Emergency Department, Hospital de la Santa Creu i Sant Pau. Sant Quinti 87, Barcelona 08025, Spain; IB Sant Pau, Research Institute. Sant Quinti 91, Barcelona 08025, Spain., Acosta-Mejuto B; Emergency Department, Hospital de la Santa Creu i Sant Pau. Sant Quinti 87, Barcelona 08025, Spain; IB Sant Pau, Research Institute. Sant Quinti 91, Barcelona 08025, Spain., Moliné-Pareja A; Autonomous University of Barcelona, Medicine Department. Plaza Cívica, Bellaterra, Cerdanyola del Valles 08193, Spain.; Emergency Department, Hospital de la Santa Creu i Sant Pau. Sant Quinti 87, Barcelona 08025, Spain; IB Sant Pau, Research Institute. Sant Quinti 91, Barcelona 08025, Spain., Ris-Romeu J; Autonomous University of Barcelona, Medicine Department. Plaza Cívica, Bellaterra, Cerdanyola del Valles 08193, Spain.; IB Sant Pau, Research Institute. Sant Quinti 91, Barcelona 08025, Spain; Urgent Care Process Hospital de la Santa Creu i Sant Pau. Sant Quintí 87, Barcelona 08025, Spain., Puig-Campmany M; Autonomous University of Barcelona, Medicine Department. Plaza Cívica, Bellaterra, Cerdanyola del Valles 08193, Spain.; Emergency Department, Hospital de la Santa Creu i Sant Pau. Sant Quinti 87, Barcelona 08025, Spain; IB Sant Pau, Research Institute. Sant Quinti 91, Barcelona 08025, Spain. Electronic address: mpuigc@santpau.cat.
Jazyk: angličtina
Zdroj: Archives of gerontology and geriatrics [Arch Gerontol Geriatr] 2023 Dec; Vol. 115, pp. 105208. Date of Electronic Publication: 2023 Sep 24.
DOI: 10.1016/j.archger.2023.105208
Abstrakt: Background: Frailty assessment allows the identification of patients at risk of death. The aim here was to study the ability of Frail-VIG Index (FI-VIG) in order to discriminate frailty groups of older adults and garner its correlation with mortality in an Emergency-Department Short-Stay Unit (ED-SSU).
Methods: Our observational, single-center, prospective study consecutively included patients over 65-years-old admitted between March 1, 2021, and April 30, 2021.
Results: 302 patients were included (56 % women), mean age 83 ± 8 years, and 39.1 % of them had a functional disability whilst 16.5 % of them had dementia. A total of 174 patients (58 %) met the frailty criteria (FI-VIG ≥ 0.2): 111 (63.8 %) had mild frailty (FI-VIG 0.2-0.36), 52 (29.9 %) had moderate frailty (FI-VIG 0.36-0.55), and 11 (6.3 %) had advanced frailty (FI-VIG > 0.55). Mortality at 30 days, 6 months, and 1 year was analyzed: no frailty was 6.3 %, 10.8 %, and 12.5 %, respectively; mild frailty was 10.8 %, 22.5 %, and 22.5 %, respectively; moderate frailty was 25 %, 34.6 %, and 42.3 %, respectively; advanced frailty was 36.4 %, 54.5 %, and 3.6 %, respectively. This shows the significant differences between the groups (1-year mortality p < 0.001). Mild frailty vs. non-frail HR was 2.47 (95 %CI 1.12-5.46), moderate frailty vs. non-frail HR was 6.93 (95 %CI 3.16-15.23), and advanced frailty vs. non-frail HR was 11.29 (95 %CI 3.54-36.03). The mean test time was 7 min.
Conclusions: There was a strong correlation between frailty degree and mortality at 1, 6, and 12 months. FI-VIG is fast and easy-to-use in this setting. It is routine implementation in ED-SSUs could enable early risk stratification.
Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest.
(Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE