Frailty Screening in the Emergency Department Enables Personalized Multidisciplinary Care for Geriatric Trauma...

Area of Science:

• Geriatric Medicine
• Trauma Surgery
• Public Health

Background:

• Frailty significantly impacts geriatric trauma patient outcomes, predicting poor recovery beyond age, comorbidities, or injury severity.
• A substantial proportion of geriatric trauma patients are identified as frail or prefrail upon emergency department admission.
• Major trauma guidelines recommend systematic frailty screening within coordinated geriatric trauma care.

Purpose of the Study:

• To review literature and identify practical instruments for frailty risk stratification in the acute trauma setting.
• To highlight the feasibility of using various instruments for frailty screening, accommodating limitations in patient history-taking.
• To outline implementation strategies for integrating frailty screening into electronic health records and care pathways.

Main Methods:

• Literature review to identify validated frailty screening instruments for acute trauma.
• Analysis of feasibility based on data acquisition methods (patient report, proxy, chart review).
• Examination of implementation strategies, including electronic health record integration and care pathway linkage.

Main Results:

• Several practical instruments are available for frailty risk stratification in trauma patients.
• Screening is feasible through diverse methods, adaptable to patient cognitive or communication status.
• Successful implementation involves embedding screening in EHRs, linked to order sets and goal-directed care pathways.

Conclusions:

• Systematic frailty screening in geriatric trauma is actionable and improves outcomes.
• Integrated care management, including early mobility, delirium prevention, and palliative care coordination, is vital.
• Resource-limited settings can adapt screening using nurse-led approaches, telehealth, and virtual interdisciplinary teams.