• QJM · Dec 2019

    Observational Study

    Frailty and hospital outcomes within a low socioeconomic population.

    • S Clark, C Shaw, A Padayachee, S Howard, K Hay, and T T Frakking.
    • Emergency Department, Caboolture Hospital, Queensland Health, McKean St, Caboolture, Queensland, Australia.
    • QJM. 2019 Dec 1; 112 (12): 907-913.

    BackgroundClinical frailty scales (CFS) predict hospital-related outcomes. Frailty is more common in areas of higher socioeconomic disadvantage, but no studies exclusively report on the impact of CFS on hospital-related outcomes in areas of known socioeconomic disadvantage.AimsTo evaluate the association of the CFS with hospital-related outcomes.DesignRetrospective observational study in a community hospital within a disadvantaged area in Australia (Social Economic Index for Areas = 0.1%).MethodsThe CFS was used in the emergency department (ED) for people aged ≥ 75 years. Frailty was defined as a score of ≥4. Associations between the CFS and mortality, admission rates, ED presentations and length of stay (LOS) were analysed using regression analyses.ResultsBetween 11 July 2017 and 31 March 2018, there were 5151 ED presentations involving 3258 patients aged ≥ 75 years. Frail persons were significantly more likely to be older, represent to the ED and have delirium compared with non-frail persons. CFS was independently associated with 28-day mortality, with odds of mortality increasing by 1.5 times per unit increase in CFS (95% CI: 1.3-1.7). Frail persons with CFS 4-6 were more likely to be admitted (OR: 1.2; 95% CI: 1.0-1.5), have higher geometric mean LOS (1.43; 95% CI 1.15-1.77 days) and higher rates of ED presentations (IRR: 1.12; 95% CI 1.04-1.21) compared with non-frail persons.ConclusionsThe CFS predicts community hospital-related outcomes in frail persons within a socioeconomic disadvantage area. Future intervention and allocation of resources could consider focusing on CFS 4-6 as a priority for frail persons within a community hospital setting.© The Author(s) 2019. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For permissions, please email: journals.permissions@oup.com.

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