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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Published in:

01-12-2021 | Care | Original research

Feasibility and accuracy of ED frailty identification in older trauma patients: a prospective multi-centre study

Authors: Heather Jarman, Robert Crouch, Mark Baxter, Chao Wang, George Peck, Dhanupriya Sivapathasuntharam, Cara Jennings, Elaine Cole

Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Issue 1/2021

Abstract

Background

The burden of frailty on older people is identifiable by its adverse effect on mortality, morbidity and long term functional and health outcomes. In patients suffering from a traumatic injury there is increasing evidence that it is frailty rather than age that impacts greatest on these outcomes and that early identification can guide frailty specific care. The aim of this study was to evaluate the feasibility of nurse-led assessment of frailty in older trauma patients in the ED in patients admitted to major trauma centres.

Methods

Patients age 65 years and over attending the Emergency Departments (ED) of five Major Trauma Centres following traumatic injury were enrolled between June 2019 and March 2020. Patients were assessed for frailty whilst in the ED using three different screening tools (Clinical Frailty Scale [CFS], Program of Research to Integrate Services for the Maintenance of Autonomy 7 [PRIMSA7], and the Trauma Specific Frailty Index [TSFI]) to compare feasibility and accuracy. Accuracy was determined by agreement with geriatrician assessment of frailty. The primary outcome was identification of frailty in the ED using three different assessment tools.

Results

We included 372 patients whose median age was 80, 53.8% of whom were female. The most common mechanism of injury was fall from less than 2 m followed by falls greater than 2 m. Completion rates for the tools were variable, 31.9% for TSFI, compared to 93% with PRISMA7 and 98.9% with the CFS. There was substantial agreement when using CFS between nurse defined frailty and geriatrician defined frailty. Agreement was moderate using PRISMA7 and slight using TSFI.

Conclusions

This prospective study has demonstrated that screening for frailty in older major trauma patients within the Emergency Department is feasible and accurate using CFS.

Trial registration

ISRCTN, ISRCTN10671514. Registered 22 October 2019

Available only for authorised users

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Title: Feasibility and accuracy of ED frailty identification in older trauma patients: a prospective multi-centre study
Authors: Heather Jarman
Robert Crouch
Mark Baxter
Chao Wang
George Peck
Dhanupriya Sivapathasuntharam
Cara Jennings
Elaine Cole
Publication date: 01-12-2021
Publisher: BioMed Central
Keyword: Care
Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine / Issue 1/2021
Electronic ISSN: 1757-7241
DOI: https://doi.org/10.1186/s13049-021-00868-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Feasibility and accuracy of ED frailty identification in older trauma patients: a prospective multi-centre study

Abstract

Background

Methods

Results

Conclusions

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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