The impact of frailty on long-term functional outcomes in severely injured geriatric patients.

Autor: Rafaqat W; Division of Trauma, Emergency General Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA., Panossian VS; Division of Trauma, Emergency General Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA., Abiad M; Division of Trauma, Emergency General Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA., Ghaddar K; Division of Trauma, Emergency General Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA., Ilkhani S; Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA., Grobman B; Harvard Medical School, Boston, MA., Herrera-Escobar JP; Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA., Salim A; Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA., Anderson GA; Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA., Sanchez S; Department of Surgery, Boston Medical Center, MA., Kaafarani HM; Division of Trauma, Emergency General Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA., Hwabejire JO; Division of Trauma, Emergency General Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA. Electronic address: jhwabejire@partners.org.
Jazyk: angličtina
Zdroj: Surgery [Surgery] 2024 Oct; Vol. 176 (4), pp. 1148-1154. Date of Electronic Publication: 2024 Aug 05.
DOI: 10.1016/j.surg.2024.06.036
Abstrakt: Background: The incidence of severe injury in the geriatric population is increasing. However, the impact of frailty on long-term outcomes after injury in this population remains understudied. Therefore, we aimed to understand the impact of frailty on long-term functional outcomes of severely injured geriatric patients.
Methods: We conducted a retrospective cohort study, including patients ≥65 years old with an Injury Severity Score ≥15, who were admitted between December 2015 and April 2022 at one of 3 level 1 trauma centers in our region. Patients were contacted between 6 and 12 months postinjury and administered a trauma quality of life survey, which assessed for the presence of new functional limitations in their activities of daily living. We defined frailty using the mFI-5 validated frailty tool: patients with a score ≥2 out of 5 were considered frail. The impact of frailty on long-term functional outcomes was assessed using 1:1 propensity matching adjusting for patient characteristics, injury characteristics, and hospital site.
Results: We included 580 patients, of whom 146 (25.2%) were frail. In a propensity-matched sample of 125 pairs, frail patients reported significantly higher functional limitations than nonfrail patients (69.6% vs 47.2%; P < .001). This difference was most prominent in the following activities: climbing stairs, walking on flat surfaces, going to the bathroom, bathing, and cooking meals. In a subgroup analysis, frail patients with traumatic brain injuries experienced significantly higher long-term functional limitations.
Conclusion: Frail geriatric patients with severe injury are more likely to have new long-term functional outcomes and may benefit from screening and postdischarge monitoring and rehabilitation services.
(Copyright © 2024. Published by Elsevier Inc.)
Databáze: MEDLINE
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