Journal article
A Prospective Comparison of Frailty Scores and Fall Prediction in Acutely Injured Older Adults
The Journal of surgical research, Vol.257, pp.326-332
01/2021
DOI: 10.1016/j.jss.2020.08.007
PMCID: PMC7736528
PMID: 32889331
Abstract
Elderly (65 and older) fall-related injuries are a significant cause of morbidity and mortality. Although frailty predicts poor outcomes in geriatric trauma, literature comparing frailty scoring systems remains limited. Herein, we evaluated which frailty scoring system best predicts falls over time in the elderly.
Acute surgical patients 65 y and older were enrolled and prospectively observed. Demographics and frailty, assessed using the FRAIL Scale, Trauma Specific Frailty Index (TSFI), and Canadian Frailty Scale (CSHA-CFS), were collected at enrollment and 3 mo intervals following discharge for 1 y. Surveys queried the total number and timing of falls. Changes in frailty over time were assessed by logistic regression and area under the curve (AUC).
Fifty-eight patients were enrolled. FRAIL Scale and CSHA-CFS scores did not change over time, but TSFI scores did (P ≤ 0.01). Worsening frailty was observed using TSFI at 6 (P ≤ 0.01) and 12 mo (P ≤ 0.01) relative to baseline. Mortality did not differ based on frailty using any frailty score. Increasing frailty scores and time postdischarge was associated with increased odds of a fall. AUC estimates with 95% CI were 0.72 [0.64, 0.80], 0.81 [0.74, 0.88], and 0.76 [0.68, 0.84] for the FRAIL Scale, TSFI, and CSHA-CFS, respectively.
The risk of falls postdischarge were associated with increased age, time postdischarge, and frailty in our population. No scale appeared to significantly outperform the other by AUC estimation. Further study on the longitudinal effects of frailty is warranted.
•No difference in mortality was observed between frail and nonfrail patients.•Worsening frailty over time was only observed with TSFI.•Higher age, time postdischarge, and frailty are associated with fall risk.•No scale significantly outperformed the other based on AUC estimation.
Details
- Title: Subtitle
- A Prospective Comparison of Frailty Scores and Fall Prediction in Acutely Injured Older Adults
- Creators
- Shawn Tejiram - University of California, DavisJulia Cartwright - University of MichiganSandra L. Taylor - University of California, DavisVictor H. Hatcher - University of IowaColette Galet - University of IowaDionne A. Skeete - University of IowaKathleen S. Romanowski - University of California, Davis
- Resource Type
- Journal article
- Publication Details
- The Journal of surgical research, Vol.257, pp.326-332
- DOI
- 10.1016/j.jss.2020.08.007
- PMID
- 32889331
- PMCID
- PMC7736528
- NLM abbreviation
- J Surg Res
- ISSN
- 0022-4804
- eISSN
- 1095-8673
- Publisher
- Elsevier Inc
- Grant note
- DOI: 10.13039/100008949, name: University of Iowa Injury Prevention Research Center; DOI: 10.13039/100005217, name: National Center for Injury Prevention and Control; DOI: 10.13039/100006108, name: National Center for Advancing Translational Sciences; DOI: 10.13039/100000002, name: National Institutes of Health
- Language
- English
- Date published
- 01/2021
- Academic Unit
- Surgery; Injury Prevention Research Center; University of Iowa Health Care
- Record Identifier
- 9984322822202771
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