Which frailty scale for patients admitted via Emergency Department? A cohort study
| Autor: | Sally McCarthy, Luis Winoto, John Mackenzie, Stephen Edward Asha, Ken Hillman, Maree Ticehurst, Elsa Dent, John Kellett, Diana Fajardo-Pulido, Hatem Alkhouri, Kris Rogers, Ebony T. Lewis, Magnolia Cardona, Margaret Williamson, Emma Elcombe, Anna Holdgate |
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| Rok vydání: | 2018 |
| Předmět: |
Gerontology
Male Aging Health (social science) Scale (ratio) Frail Elderly Asha 03 medical and health sciences 0302 clinical medicine Humans Frail elderly 030212 general & internal medicine Prospective Studies Self report Prospective cohort study Aged Aged 80 and over 030214 geriatrics Frailty Geriatric assessment Emergency department Female Geriatrics and Gerontology Psychology Emergency Service Hospital Cohort study |
| Zdroj: | Lewis, E T, Dent, E, Alkhouri, H, Kellett, J, Williamson, M, Asha, S, Holdgate, A, Mackenzie, J, Winoto, L, Fajardo-Pulido, D, Ticehurst, M, Hillman, K, McCarthy, S, Elcombe, E, Rogers, K & Cardona, M 2019, ' Which frailty scale for patients admitted via Emergency Department? A cohort study ', Archives of Gerontology and Geriatrics, vol. 80, pp. 104-114 . https://doi.org/10.1016/j.archger.2018.11.002 |
| ISSN: | 1872-6976 |
| DOI: | 10.1016/j.archger.2018.11.002 |
| Popis: | OBJECTIVES: To determine the prevalence of frailty in Emergency Departments (EDs); examine the ability of frailty to predict poor outcomes post-discharge; and identify the most appropriate instrument for routine ED use.METHODS: In this prospective study we simultaneously assessed adults 65+yrs admitted and/or spent one night in the ED using Fried, the Clinical Frailty Scale (CFS), and SUHB (Stable, Unstable, Help to walk, Bedbound) scales in four Australian EDs for rapid recognition of frailty between June 2015 and March 2016.RESULTS: 899 adults with complete follow-up data (mean (SD) age 80.0 (8.3) years; female 51.4%) were screened for frailty. Although different scales yielded vastly different frailty prevalence (SUHB 9.7%, Fried 30.4%, CFS 43.7%), predictive discrimination of poor discharge outcomes (death, poor self-reported health/quality of life, need for community services post-discharge, or reattendance to ED after the index hospitalization) for all identical final models was equivalent across all scales (AUROC 0.735 for Fried, 0.730 for CFS and 0.720 for SUHB).CONCLUSION: This study confirms that screening for frailty in older ED patients can inform prognosis and target discharge planning including community services required. The CFS was as accurate as the Fried and SUHB in predicting poor outcomes, but more practical for use in busy clinical environments with lower level of disruption. Given the limitations of objectively measuring frailty parameters, self-report and clinical judgment can reliably substitute the assessment in EDs. We propose that in a busy ED environment, frailty scores could be used as a red flag for poor follow-up outcome. |
| Databáze: | OpenAIRE |
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