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. LEVEL OF EVIDENCE: Prognostic study, level II.
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 traumapatients. METHODS: We performed a 1-year prospective study at our Level 1 trauma center. All traumapatients 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 traumapatients 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 traumapatients. LEVEL OF EVIDENCE: Prognostic study, level II.
Authors: Frank Z Zhao; Steven E Wolf; Paul A Nakonezny; Abu Minhajuddin; Ramona L Rhodes; M Elizabeth Paulk; Herb A Phelan Journal: J Palliat Med Date: 2015-05-14 Impact factor: 2.947
Authors: Christine M Leeper; Elizabeth Lin; Marcus Hoffman; Anisleidy Fombona; Tianhua Zhou; Matthew Kutcher; Matthew Rosengart; Gregory Watson; Timothy Billiar; Andrew Peitzman; Brian Zuckerbraun; Jason Sperry Journal: J Trauma Acute Care Surg Date: 2016-05 Impact factor: 3.313
Authors: Sheryl K Ramdass; Maura J Brennan; Rebecca Starr; Peter K Lindenauer; Xiaoxia Liu; Penelope Pekow; Mihaela S Stefan Journal: J Hosp Med Date: 2017-12-06 Impact factor: 2.960
Authors: R S Friese; J Wynne; B Joseph; A Hashmi; C Diven; V Pandit; T O'Keeffe; B Zangbar; N Kulvatunyou; P Rhee Journal: Eur J Trauma Emerg Surg Date: 2014-02-21 Impact factor: 3.693
Authors: Stephanie N Lueckel; Joan M Teno; Andrew H Stephen; Eric Benoit; Tareq Kheirbek; Charles A Adams; William G Cioffi; Kali S Thomas Journal: J Head Trauma Rehabil Date: 2019 Jan/Feb Impact factor: 2.710
Authors: Claire Sokas; Katherine C Lee; Daniel Sturgeon; Jocelyn Streid; Stuart R Lipsitz; Joel S Weissman; Dae H Kim; Zara Cooper Journal: J Pain Symptom Manage Date: 2020-11-16 Impact factor: 5.576