• Surgery · Sep 2019

    Prospective evaluation of health-related quality of life in geriatric trauma patients.

    • Chelsey Santino, Muhammad Zeeshan, Mohammad Hamidi, Kamil Hanna, Abdul Tawab Saljuqi, Narong Kulvatunyou, Zaid Haddadin, Ashley Northcutt, and Bellal Joseph.
    • Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ.
    • Surgery. 2019 Sep 1; 166 (3): 403-407.

    BackgroundFrailty is an established predictor of adverse outcomes in geriatric patients. Health-related quality of life (HRQoL) is an important outcome measure among trauma patients. This prospective observational study examined the impact of frailty on health-related quality of life in geriatric trauma patients.MethodsWe prospectively enrolled geriatric (age ≥65 years) trauma patients. We calculated the frailty index (FI) within 24 hours of admission using the trauma-specific frailty index. Patients were stratified into frail (frailty index ≥0.27) and nonfrail (frailty index <0.27). Health-related quality of life was calculated at discharge and at 30 days (day) after discharge using the RAND Short Form-36 (SF-36). Outcome measures were health-related quality of life at discharge, 30-days postdischarge, and delta health-related quality of life. Regression analysis was performed to control for demographic, vital signs, and injury parameters.ResultsWe enrolled 296 patients. The mean age was 75.1 ± 9.8 years, 59% were male, and 81% were white. Frail patients accounted for 34%, and they had a lower health-related quality of life at discharge (366 vs 548, P < .01) and at 30-day postdischarge (393 vs 744, P < .01). Nonfrail patients scored higher in 6 out of 8 domains of health-related quality of life. Nonfrail patients had improved delta health-related quality of life (P < .01), unlike frail patients (P = .11). A linear regression model revealed an inverse relationship between frailty and improvement in health-related quality of life over 30-day postdischarge (β = -0.689, [confidence interval, -0.963 to -0.329] P = .01). This association remained statistically significant after controlling for potential confounding covariates, such as age, sex, race, and injury severity.ConclusionCompared with nonfrail geriatric trauma patients, those who were frail had poor health-related quality of life at discharge and at 30-day postdischarge. Frailty negatively affects the recovery of health-related quality of life after trauma. The use of frailty indices may help identify and develop targeted interventions to improve health-related quality of life among geriatric trauma patients.Copyright © 2019 Elsevier Inc. All rights reserved.

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