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Clinical Frailty Scale (CFS) in the orthogeriatric population: Association between frailty and prespecified key
Thomas Cloney1, Clara McGurk1, Christine McCarthy2
1Department of Geriatric Medicine, Cork University Hospital, Wilton, Cork, Ireland.
Insights
Increased frailty in older adults with hip fractures is linked to longer hospital stays, higher mortality, and more nursing home admissions. This highlights the critical impact of frailty on patient outcomes following hip fracture.
Area of Science:
- Geriatric Medicine
- Orthopaedic Surgery
- Epidemiology
Background:
- Cork University Hospital (CUH) manages nearly 500 hip fractures annually through a dedicated Orthopaedic-Orthogeriatric co-management service.
- All patients aged 60+ admitted with hip fracture at CUH undergo comprehensive geriatric assessment (CGA) and frailty status documentation.
Purpose of the Study:
- To investigate the clinical epidemiology of hip fractures in an Irish specialist orthopaedic unit.
- To analyze the association between Clinical Frailty Scale (CFS) and key patient outcomes.
Main Methods:
- Data collected from the Irish Hip Fracture Database (IHFD) between July 2019 and September 2021.
- Included adults aged 60+ admitted to CUH with hip fracture.
- Outcomes analyzed: Length of Stay (LOS), inpatient mortality, and discharge to nursing home care, in relation to CFS.
Main Results:
- 1132 patients met the inclusion criteria.
- Higher levels of frailty (moderate to severe) correlated with increased LOS.
- Increased frailty was associated with higher inpatient mortality and a greater likelihood of discharge to nursing home care.
Conclusions:
- Very mild to severe frailty significantly increases the risk of hip fracture from low-trauma events.
- The study provides robust evidence demonstrating a clear link between frailty and adverse clinical outcomes in hip fracture patients.
Background:
Cork University Hospital (CUH) is a model 4 tertiary referral centre in the south of Ireland. A robust Orthopaedic - Orthogeriatric co-management service manages close to 500 hip fractures per year. At CUH all adults aged 60 years or older admitted with hip fracture receive comprehensive geriatric assessment (CGA) and documentation of their frailty status.
Objective:
This study aims to review the clinical epidemiology of hip fractures in a specialist orthopaedic unit in Ireland, while examining the association between CFS and prespecified patient outcomes.
Design & Methods:
Utilising the Irish hip fracture database (IHFD), we collected data between 1st July 2019 to September 30th 2021. Eligible cases were all adults aged 60 years and older admitted to CUH with hip fracture as defined by IHFD. Prespecified outcomes included Length of Stay (LOS), inpatient mortality and new admission to nursing home care and these were analysed in relation to a patients CFS.
Results:
1132 adults met fracture criteria and were included in the study. Increasing frailty, specifically moderate to severe frailty was associated with increased LOS, inpatient mortality and increased likelihood of discharge to nursing home care when compared to those were not frail or who had very mild to moderate frailty.
Conclusions:
People living with very mild to moderate frailty and severe frailty are at significant risk of hip fracture following low volume trauma. With approximately two years of hip fracture data, we found visible, generalizable data demonstrating the association between frailty and clinical outcomes.
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