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Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
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Pretrauma Functional Independence Measure Score Predicts Survival in Geriatric Trauma.

Brian Fletcher, Eric Bradburn, Christopher Baker

    The American Surgeon
    |June 23, 2017
    PubMed
    Summary

    Pretrauma Functional Independence Measure (FIM) scores predict survival in geriatric trauma patients. Higher FIM scores indicate better function and are associated with increased odds of survival in elderly trauma victims.

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    Area of Science:

    • Geriatric Trauma Care
    • Rehabilitation Medicine
    • Outcome Prediction

    Background:

    • Geriatric trauma patients are a growing focus for trauma services.
    • The Functional Independence Measure (FIM) assesses disability by combining motor and cognitive function for activities of daily living (ADL).
    • Previous studies show FIM predicts discharge outcomes and fall risk in geriatric populations.

    Purpose of the Study:

    • To investigate if pretrauma Functional Independence Measure (FIM) scores can predict survival in geriatric trauma patients.
    • To identify factors contributing to survival in elderly individuals admitted to a Level I trauma center.

    Main Methods:

    • Retrospective study of 941 geriatric trauma patients (≥65 years) admitted between 2006-2012.
    • Stepwise and multiple logistic regression analyses were used to identify predictors of survival.
    • Variables analyzed included age, Injury Severity Score (ISS), revised trauma score (RTS), body mass index (BMI), and pretrauma FIM scores.

    Main Results:

    • Overall mortality was 11% among the study cohort.
    • Each 1-point increase in preadmission FIM score was associated with a 3.532 times greater odds of survival (95% CI: 2.191-5.718).
    • Glasgow Coma Scale (GCS), RTS, gender, and pretrauma FIM scores were significant predictors of survival.

    Conclusions:

    • Preadmission FIM scores are a significant predictor of survival in elderly trauma patients.
    • FIM assessment may offer valuable prognostic information for geriatric trauma victims.
    • Further research is warranted to integrate FIM into established trauma scoring systems for enhanced predictive accuracy.