Screening for Frailty in Older Emergency Patients and Association with Outcome

Area of Science:

• Gerontology
• Emergency Medicine
• Clinical Assessment

Background:

• Older adults frequently experience adverse outcomes following urgent care.
• Early identification of high-risk elderly patients is essential for timely interventions.
• The Frailsafe screening tool was developed to assess frailty in older adults.

Purpose of the Study:

• To evaluate the effectiveness of the Frailsafe three-point screening questions in identifying older adults at high risk of adverse outcomes.
• To determine if Frailsafe status predicts mortality and other negative outcomes in elderly Emergency Department attendees.

Main Methods:

• A prospective study involving consecutive unplanned Emergency Department (ED) attendances of patients aged 75 years and older.
• Frailsafe screening was administered to assess patient frailty status.
• Primary outcome was 180-day mortality; secondary outcomes included care home admission, prolonged hospital stay, and re-attendance.

Main Results:

• 54.5% of 356 assessed patients were Frailsafe positive.
• A positive Frailsafe screen independently predicted 180-day mortality (AOR = 3.23).
• Frailsafe positivity also predicted new care home admission (AOR = 8.95), prolonged length of stay (>28 days, AOR = 3.42), and 30-day re-attendance (OR = 2.73).

Conclusions:

• The Frailsafe screening tool is a valuable and independent predictor of adverse outcomes in older adults presenting to the Emergency Department.
• Implementing Frailsafe screening can aid in risk stratification and resource allocation for high-risk elderly patients.
• Further research should explore interventions based on Frailsafe screening results to improve patient outcomes.