Canadian Study of Health and Aging Clinical Frailty Scale: Does It Predict Adverse Outcomes among Geriatric Trauma Patients?

Complementing chronic frailty assessment at hospital admission with an electronic frailty index (FI-Laboratory) comprising routine blood test results

“…We found that the FI-Laboratory was associated with discharge location. We believe this may reflect our study's increased power; however, Cheung and colleagues 23 included a trauma-specific severity measure in their multivariable analysis. In a 2017 study with a large general older population who presented to hospital, an acute FI-Laboratory score was associated with inpatient and postdischarge mortality; however, critically, the authors did not account for frailty beyond the FI-Laboratory.…”

“…24 In a Canadian study, 266 older patients with trauma were investigated by employing both an FI-Laboratory score and the CFS. 23 In a univariable analysis, the authors found that the CFS was associated with more inpatient complications and the FI-Laboratory score was associated with adverse discharge destination. They did not report on the association of FI-Laboratory* 1.61 (1.54-1.69) 1.47 (1.41-1.54) 1.40 (1.29-1.53) 1.39 (1.27-1.52) 1.20 (1.12-1.28) 1.18 (1.11-1.26) 1.51 (1.43-1.60) 1. inpatient complications with the FI-Laboratory score.…”

“…13,20,21 Moreover, FI-Laboratory scores contribute additional quantification of risk over and above clinical assessments of frailty. [8][9][10]22,23 In the acute setting, where a range of laboratory investigations are routinely undertaken and readily available in electronic health records, creating an FI-Laboratory captures the number of deficits on presentation in a standardized way. Initial studies among patients with trauma found that a high admission FI-Laboratory, in isolation, predicted a less favourable discharge location and mortality.…”

“…Initial studies among patients with trauma found that a high admission FI-Laboratory, in isolation, predicted a less favourable discharge location and mortality. [23][24][25] If identifying the severity of illness of patients who are frail at presentation to hospital is important for the early care plan, 6,26 then the FI-Laboratory may be a plausible "front door" tool that could inform potential interventions that may include management escalation, specific treatment paths, implementation of comprehensive geriatric assessments 27 and admission to "senior-friendly" units. 28 We evaluated the association of FI-Laboratory, created at admission with common laboratory tests, with clinical frailty in relation to short-term outcomes (i.e., length of stay, a higher level of care upon discharge and in-hospital mortality) and long-term outcomes (i.e.,overall mortality, mortality after discharge and readmission).…”

Radiographic assessment of sarcopenia in the trauma setting: a systematic review

“…Of note, the demographic characteristics and outcomes of patients with sarcopenia broadly parallel outcomes seen with the syndrome of frailty, with most frail patients exhibiting some evidence of sarcopenia 29. Although a uniform definition of frailty has yet to emerge, it has come to be recognized as a syndrome broadly characterized by diminished strength, endurance, and reduced physiologic function that thereby increases a person’s vulnerability for developing increased dependency and/or death 30.…”