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Screening for frailty in older emergency patients and association with outcome

Lewis, Siobhan, Evans, Louis, Rainer, Timothy and Hewitt, Jonathan 2020. Screening for frailty in older emergency patients and association with outcome. Geriatrics 5 (1) , 20. 10.3390/geriatrics5010020

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Abstract

Older people have a high incidence of adverse outcomes after urgent care presentation. Identifying high-risk older patients early is key to targeting interventions at those patients most likely to benefit. This study used the Frailsafe three-point screening questions amongst older Emergency Department (ED) attendees. Consecutive unplanned ED attendances in patients aged ≥75 were assessed for Frailsafe status. The primary outcome was mortality at 180 days. A Frailsafe screen was completed in 356 patients, of whom 194/356 (54.5%) were Frailsafe positive. The mean age was 85.8 for Frailsafe screen positive and 82.2 for Frailsafe screen negative patients (p < 0.001). A positive Frailsafe screen was a predictor of death within 180 days of presentation to the ED and remained so after adjustment (AOR = 3.23, 95% CI 1.45–7.19, p = 0.004). A positive Frailsafe screen was an independent predictor of a new care home admission at 180 days (AOR = 8.95, 95% CI 2.01–39.83, p = 0.004). A positive Frailsafe screen was also predictive of a number of secondary outcomes, such as length of stay of >28 days (AOR 3.42, 95% CI 1.41–8.31, p = 0.007) and re-attendance within 30 days of discharge after admission (OR = 2.73, 95% CI 1.27–5.88, p = 0.01). Frailsafe screen results independently predict a range of outcomes amongst older ED attendees.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Publisher: MDPI AG
ISSN: 2308-3417
Date of First Compliant Deposit: 14 May 2021
Date of Acceptance: 10 March 2020
Last Modified: 18 May 2021 15:45
URI: http://orca.cardiff.ac.uk/id/eprint/141327

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