Age and ageing
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Multicenter Study
Identification of older adults with frailty in the Emergency Department using a frailty index: results from a multinational study.
frailty is a central concept in geriatric medicine, yet its utility in the Emergency Department (ED) is not well understood nor well utilised. Our objectives were to develop an ED frailty index (FI-ED), using the Rockwood cumulative deficits model and to evaluate its association with adverse outcomes. ⋯ the FI-ED conformed to characteristics previously reported. A FI, developed and validated from a brief geriatric assessment tool could be used to identify ED patients at higher risk of adverse events.
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two popular operational definitions of frailty, the frailty phenotype and Frailty index (FI), are based on different theories. Although FI was shown to be superior in predicting mortality to the frailty phenotype, no meta-analysis on mortality risk according to FI has been found in the literature. ⋯ this systematic review and meta-analysis was the first to quantitatively demonstrate that frailty measured by the FI is a significant predictor of mortality.
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Multicenter Study
Improving patient safety for older people in acute admissions: implementation of the Frailsafe checklist in 12 hospitals across the UK.
checklists are increasingly proposed as a means to enhance safety and quality of care. However, their use has been met with variable levels of success. The Frailsafe project focused on introducing a checklist with the aim to increase completion of key clinical assessments and to facilitate communication for the care of older patients in acute admissions. ⋯ the Frailsafe checklist highlighted limitations with frailty assessment in acute care and motivated teams to review routine practices. Further work is needed to understand whether and how checklists can be embedded in complex, multidisciplinary care.
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Comparative Study
A greater risk of premature death in residential respite care: a national cohort study.
the demand for residential respite care for older persons is high yet little is known about the occurrence of harm, including death in this care setting. ⋯ this is the first national cohort study examining mortality among respite residents. It established that premature, injury-related deaths do occur during respite care. This is the first step towards better understanding and reducing the risk of harm in respite care.
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to investigate how frailty and frailty symptoms affect healthcare costs in older age longitudinally. ⋯ our data stress the economic relevance of frailty in late life. Postponing or reducing frailty might be fruitful in order to reduce healthcare costs.