Clinical Frailty and Functional Trajectories in Hospitalized Older Adults: a Retrospective Observational Study
Geriatrics & Gerontology International
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Hartley, P., Adamson, J., Cunningham, C., Embleton, G., & Romero-Ortuno, R. (2016). Clinical Frailty and Functional Trajectories in Hospitalized Older Adults: a Retrospective Observational Study. Geriatrics & Gerontology International, 17 1068. https://doi.org/10.1111/ggi.12827
Aim: frailty predicts inpatient mortality and length of stay, but its link to functional trajectories is under researched. Our hospital collects the Clinical Frailty Scale (CFS) within 72 hours of admission in those aged ≥75. We studied whether the CFS links to functional trajectories in hospitalized older adults. Methods: retrospective observational study in an English university hospital. We analysed all first episodes of county residents aged ≥75 admitted to the Department of Medicine for the Elderly (DME) wards between December 2014 and May 2015. Data was extracted from the hospital’s information systems. Patients were classified as non-frail (CFS 1-4), moderately frail (CFS 5-6) and severely frail (CFS 7-8). Function was retrospectively measured with the modified Rankin Scale (mRS) at preadmission, admission and discharge. Results: of 539 eligible patients, 46 died during admission (mortality rates: 2% in CFS 1-4, 5% in CFS 5-6, 19% in CFS 7-8). Among the 493 survivors, 121 were non-frail, 235 moderately, and 137 severely frail. The mean (95% CI) mRS of the non-frail was 1.8 (1.7-2.0) at baseline, 3.3 (3.1-3.5) on admission and 2.2 (2.0-2.3) on discharge (mean LOS 9 days). The moderately frail had mean mRS of 2.9 (2.8-3.0), 4.0 (3.8-4.1) and 3.2 (3.1-3.3) (mean LOS 15 days). The severely frail had mean mRS of 3.5 (3.3-3.6), 4.3 (4.1-4.4) and 3.7 (3.6-3.9), respectively (mean LOS 17 days). Conclusions: in older inpatients, frailty may be linked to lower and slower functional recovery. Prospective work is needed to confirm these trajectories and understand how to influence them.
frail elderly, disability, functional trajectory, hospital medicine, clinical frailty scale
Funding was not required for this study.
External DOI: https://doi.org/10.1111/ggi.12827
This record's URL: https://www.repository.cam.ac.uk/handle/1810/255748