Journal article
Predicting hospital discharge disposition in geriatric trauma patients: Is frailty the answer?
The journal of trauma and acute care surgery, Vol.76(1), pp.196-204
01/01/2014
DOI: 10.1097/TA.0b013e3182a833ac
PMID: 24368379
Abstract
BACKGROUND: The frailty index (FI) has been shown to predict outcomes in geriatric patients. However, FI has never been applied as a prognostic measure after trauma. The aim of our study was to identify hospital admission factors predicting discharge disposition in geriatric trauma patients.
METHODS: We performed a 1-year prospective study at our Level 1 trauma center. All trauma patients 65 years or older were enrolled. FI was calculated using 50 preadmission variables. Patient's discharge disposition was dichotomized as favorable outcome (discharge home, rehabilitation) or unfavorable outcomes (discharge to skilled nursing facility, death). Multivariate logistic regression was performed to identify factors that predict unfavorable outcome.
RESULTS: A total of 100 patients were enrolled, with a mean (SD) age of 76.51 (8.5) years, 59% being males, median Injury Severity Score (ISS) of 14 (range, 9-18), median head Abbreviated Injury Scale (h-AIS) score of 2 (2-3), and median Glasgow Coma Scale (GCS) score of 13 (12-15). Of the patients, 69% had favorable outcome, and 31% had unfavorable outcome. On univariate analysis, FI was found to be a significant predictor for unfavorable outcome (odds ratio, 1.8; 95% confidence interval, 1.2-2.3). After adjusting for age, ISS, and GCS score in a multivariate regression model, FI remained a strong predictor for unfavorable discharge disposition (odds ratio, 1.3; 95% confidence interval, 1.1-1.8).
CONCLUSION: The concept of frailty can be implemented in geriatric trauma patients with similar results as those of nontrauma and nonsurgical patients. FI is a significant predictor of unfavorable discharge disposition and should be an integral part of the assessment tools to determine discharge disposition for geriatric trauma patients. Copyright (C) 2014 by Lippincott Williams & Wilkins
Details
- Title: Subtitle
- Predicting hospital discharge disposition in geriatric trauma patients: Is frailty the answer?
- Creators
- Bellal Joseph - Banner - University Medical Center TucsonViraj Pandit - Banner - University Medical Center TucsonPeter Rhee - Banner - University Medical Center TucsonHassan Aziz - Banner - University Medical Center TucsonMoutamn Sadoun - Banner - University Medical Center TucsonJulie Wynne - Banner - University Medical Center TucsonAndrew Tang - Banner - University Medical Center TucsonNarong Kulvatunyou - Banner - University Medical Center TucsonTerence O'Keeffe - University of ArizonaMindy J. Fain - Banner - University Medical Center TucsonRandall S. Friese - Banner - University Medical Center Tucson
- Resource Type
- Journal article
- Publication Details
- The journal of trauma and acute care surgery, Vol.76(1), pp.196-204
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1097/TA.0b013e3182a833ac
- PMID
- 24368379
- ISSN
- 2163-0755
- eISSN
- 2163-0763
- Number of pages
- 9
- Language
- English
- Date published
- 01/01/2014
- Academic Unit
- Surgery
- Record Identifier
- 9984701649802771
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