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Measuring Frailty Can Help Emergency Departments Identify Independent Seniors at Risk of Functional Decline After Minor Injuries.
- Source :
-
Journals of Gerontology Series A: Biological Sciences & Medical Sciences . Jan2017, Vol. 72 Issue 1, p68-74. 7p. 3 Charts. - Publication Year :
- 2017
-
Abstract
- <bold>Background: </bold>This study aims to (i) describe frailty in the subgroup of independent community-dwelling seniors consulting emergency departments (EDs) for minor injuries, (ii) examine the association between frailty and functional decline 3 months postinjury, (iii) ascertain the predictive accuracy of frailty measures and emergency physicians' for functional decline.<bold>Method: </bold>Prospective cohort in 2011-2013 among 1,072 seniors aged 65 years or older, independent in basic daily activities, evaluated in Canadian EDs for minor injuries.Frailty was assessed at EDs using the Canadian Study of Health and Aging-Clinical Frailty scale (CSHA-CFS) and the Study of Osteoporotic Fracture frailty index (SOF). Functional decline was defined as a loss ≥2/28 on the Older American Resources Services scale 3 months postinjury. Generalized mixed models were used to explore differences in functional decline across frailty levels. Areas under the receiver operating characteristic curve were used to ascertain the predictive accuracy of frailty measures and emergency physicians' clinical judgment.<bold>Results: </bold>The SOF and CSHA-CFS were available in 342 and 1,058 participants, respectively. The SOF identified 55.6%, 32.7%, 11.7% patients as robust, prefrail, and frail. These CSHA-CFS (n = 1,058) proportions were 51.9%, 38.3%, and 9.9%. The 3-month incidence of functional decline was 12.1% (10.0%-14.6%). The Areas under the receiver operating characteristic curves of the CSHA-CFS and the emergency physicians' were similar (0.548-0.777), while the SOF was somewhat higher (0.704-0.859).<bold>Conclusion: </bold>Measuring frailty in community-dwelling seniors with minor injuries in EDs may enhance current risk screening for functional decline. However, before implementation in usual care, feasibility issues such as inter-rater reliability and acceptability of frailty tools in the EDs have to be addressed. [ABSTRACT FROM AUTHOR]
- Subjects :
- *HOSPITAL emergency services
*FUNCTIONAL loss in older people
*EMERGENCY physicians
*OARS Multidimensional Functional Assessment Questionnaire
*FRAGILITY (Psychology)
*GERIATRIC assessment
*COMPARATIVE studies
*FRAIL elderly
*HEALTH status indicators
*RESEARCH methodology
*MEDICAL cooperation
*RESEARCH
*RISK assessment
*WOUNDS & injuries
*ACTIVITIES of daily living
*EVALUATION research
*PREDICTIVE tests
*INDEPENDENT living
Subjects
Details
- Language :
- English
- ISSN :
- 10795006
- Volume :
- 72
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- Journals of Gerontology Series A: Biological Sciences & Medical Sciences
- Publication Type :
- Academic Journal
- Accession number :
- 120244270
- Full Text :
- https://doi.org/10.1093/gerona/glv152