Academic Journal

Which frailty scale for patients admitted via emergency department? : a cohort study

التفاصيل البيبلوغرافية
العنوان: Which frailty scale for patients admitted via emergency department? : a cohort study
المؤلفون: Lewis, Ebony, Dent, Elsa, Alkhouri, Hatem, Kellett, John, Williamson, Margaret, Asha, Stephen, Holdgate, Anna, Mackenzie, John, Winoto, Luis, Fajardo-Pulido, Diana, Ticehurst, Maree, Hillman, Ken M., McCarthy, Sally, Elcombe, Emma (R18808), Rogers, Kris D., Cardona-Morrell, Magnolia
المساهمون: School of Nursing and Midwifery (Host institution)
بيانات النشر: Ireland, Elsevier Ireland
سنة النشر: 2019
المجموعة: University of Western Sydney (UWS): Research Direct
مصطلحات موضوعية: XXXXXX - Unknown, hospitals, emergency departments, frailty (psychology), frail elderly
الوصف: 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.
نوع الوثيقة: article in journal/newspaper
وصف الملف: print
اللغة: English
Relation: NHMRC 1054146 & 1112672; http://purl.org/au-research/grants/nhmrc/1054146; http://purl.org/au-research/grants/nhmrc/1112672; Archives of Gerontology and Geriatrics--0167-4943--1872-6976 Vol. 80 Issue. No. pp: 104-114
DOI: 10.1016/j.archger.2018.11.002
الاتاحة: https://doi.org/10.1016/j.archger.2018.11.002
http://handle.westernsydney.edu.au:8081/1959.7/uws:50854
Rights: © 2018 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/BY-NC-ND/4.0/).
رقم الانضمام: edsbas.D691B4FF
قاعدة البيانات: BASE
الوصف
DOI:10.1016/j.archger.2018.11.002