FRAILTY ASSESSMENT IN THE EMERGENCY DEPARTMENT

Title

FRAILTY ASSESSMENT IN THE EMERGENCY DEPARTMENT

Creator

Stiffler K A; Finley A; Midha S; Wilber S T

Publisher

Journal of Emergency Medicine

Date

2013
2013-08

Description

Background: Frailty (defined as weakness, slowness, weight loss, exhaustion, and physical inactivity) is characterized by increased vulnerability to stressors. Frail older patients are at increased risk of Emergency Department (ED) visits, hospitalization, disability, and death. Objectives: Our aims were to determine the prevalence of frailty (and assess the feasibility of measuring frailty) in older ED patients. We also assessed the correlation of self-reported speed and weakness to measured values and the association between frailty and function. Methods: We performed a study of discharged ED patients aged >= 65 years. We used Fried's frailty definition and a validated activities-of-daily-living (ADL) scale. We measured self-reported and objective weakness and slowness. Data were reported as means and proportions with 95% confidence interval (CI); associations were measured using 95% CI for the differences. Ninety patients provided a 95% CI of +/- 10%. Results: The mean age of the 90 patients was 76 +/- 6.4 SD years; 51% were male. Mean assessment time was 7.4 min (95% CI 6.9-7.9). Twenty percent of patients were frail (18/90, 95% CI 12-30%). Self-report was 18% sensitive and 90% specific for objective weakness; self-report was 42% sensitive and 86% specific for objective slowness. Frail and weak patients were more likely dependent in one or more ADLs (26% difference, 95% CI 1-51% and 20% difference, 95% CI 1-41%, respectively). Conclusions: Frailty is common in discharged older ED patients. Self-reported weakness and slowness are poor predictors of their objective counterparts. Frailty was associated with ADL dependence. These two domains may be reliable markers for elderly ED patients at high risk for adverse outcomes. (C) 2013 Elsevier Inc.

Subject

disability; Emergency Medicine; fractures; functional decline; gait speed; geriatrics; identification; indexes; intervention; mortality; muscle weakness; older-adults; prediction; risk-stratification tool

Format

Journal Article

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Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Pages

291-297

Issue

2

Volume

45

Citation

Stiffler K A; Finley A; Midha S; Wilber S T, “FRAILTY ASSESSMENT IN THE EMERGENCY DEPARTMENT,” NEOMED Bibliography Database, accessed July 24, 2021, https://neomed.omeka.net/items/show/7237.

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