137 Does the Clinical Frailty Scale Predict Rehabilitation Potential in Older Patients?

Abstract

Background The Clinical Frailty Scale (CFS) is widely used to assess frailty in older adults and reflects functional independence. We examined its use as an outcome measure in an offsite rehabilitation unit for patients over 65 transferred from an acute hospital following medical/surgical admission. Methods Patients were given a CFS score by consensus opinion from the multidisciplinary team on admission and on completion of rehabilitation. We included data on diagnosis, length of stay and discharge destination Results Thirty patients, with a mean age of 80, completed rehabilitation over a four-month period. The most common diagnosis was fracture of hip or pelvis (53%). Median CFS was 6 on admission and 5 on discharge (range 3-8). Twenty-one (70%) patients saw an improvement in CFS of an average of one point on the scale irrespective of admission score. Of those that improved, 81% were discharged directly home with no need for increased support services, compared with 11% of those who did not improve. Mean length of stay was significantly less in those with mild/moderate frailty (CFS 5-6) at admission versus severe frailty (31 vs 53.8 days, p<0.01). Conclusion Frailty score improved in the majority of patients undergoing rehabilitation, regardless of admission score; CFS alone did not predict rehabilitation potential, emphasising the importance of offering rehabilitation to frail older adults – better judged by experienced clinical assessment. CFS is a broad 9-point tool that can miss small improvements in physical function based on other objective scores e.g. FIM+FAM. Severe frailty was associated with longer length of stay in rehabilitation, possibly reflecting more complex discharge planning as well as rehabilitation progress in this group.

Assessment Tools for the Admission of Older Adults to Inpatient Rehabilitation: A Scoping Review

“…GR is qualitative and patient-specific. Nevertheless, studies regarded outcomes of rehabilitation as a yardstick for which to measure the degree of success or otherwise of the rehabilitation process [19,20]. These have been associated with the following: shorter length of stay; reduced mortality; return to previous home in the community; avoiding admission to nursing homes; and remaining out of hospital once discharged [2,4,[21][22][23][24][25].…”