Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/117952
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dc.contributor.authorLewis, E.T.en
dc.contributor.authorDent, E.en
dc.contributor.authorAlkhouri, H.en
dc.contributor.authorKellett, J.en
dc.contributor.authorWilliamson, M.en
dc.contributor.authorAsha, S.en
dc.contributor.authorHoldgate, A.en
dc.contributor.authorMackenzie, J.en
dc.contributor.authorWinoto, L.en
dc.contributor.authorFajardo-Pulido, D.en
dc.contributor.authorTicehurst, M.en
dc.contributor.authorHillman, K.en
dc.contributor.authorMcCarthy, S.en
dc.contributor.authorElcombe, E.en
dc.contributor.authorRogers, K.en
dc.contributor.authorCardona, M.en
dc.date.issued2019en
dc.identifier.citationArchives of Gerontology and Geriatrics, 2019; 80:104-114en
dc.identifier.issn0167-4943en
dc.identifier.issn1872-6976en
dc.identifier.urihttp://hdl.handle.net/2440/117952-
dc.description.abstractObjectives: To determine the prevalence of frailty in Emergency Departments (EDs); examine the ability of frailty to predict poor outcomes post-discharge; and identify the most appropriate instrument for routine ED use. Methods: In this prospective study we simultaneously assessed adults 65+yrs admitted and/or spent one night in the ED using Fried, the Clinical Frailty Scale (CFS), and SUHB (Stable, Unstable, Help to walk, Bedbound) scales in four Australian EDs for rapid recognition of frailty between June 2015 and March 2016. Results: 899 adults with complete follow-up data (mean (SD) age 80.0 (8.3) years; female 51.4%) were screened for frailty. Although different scales yielded vastly different frailty prevalence (SUHB 9.7%, Fried 30.4%, CFS 43.7%), predictive discrimination of poor discharge outcomes (death, poor self-reported health/quality of life, need for community services post-discharge, or reattendance to ED after the index hospitalization) for all identical final models was equivalent across all scales (AUROC 0.735 for Fried, 0.730 for CFS and 0.720 for SUHB). Conclusion: This study confirms that screening for frailty in older ED patients can inform prognosis and target discharge planning including community services required. The CFS was as accurate as the Fried and SUHB in predicting poor outcomes, but more practical for use in busy clinical environments with lower level of disruption. Given the limitations of objectively measuring frailty parameters, self-report and clinical judgment can reliably substitute the assessment in EDs. We propose that in a busy ED environment, frailty scores could be used as a red flag for poor follow-up outcome.en
dc.description.statementofresponsibilityEbony T. Lewis, Elsa Dent, Hatem Alkhouri, John Kellett, Margaret Williamson, Stephen Asha, Anna Holdgate, John Mackenzie, Luis Winoto, Diana Fajardo-Pulido, Maree Ticehurst, Ken Hillman, Sally McCarthy, Emma Elcombe, Kris Rogers, Magnolia Cardonaen
dc.language.isoenen
dc.publisherElsevieren
dc.rights© 2018 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/BY-NC-ND/4.0/).en
dc.subjectGeriatric assessment; emergency department; frail elderly; self-report; prospective studiesen
dc.titleWhich frailty scale for patients admitted via Emergency Department? A cohort studyen
dc.typeJournal articleen
dc.identifier.rmid0030108148en
dc.identifier.doi10.1016/j.archger.2018.11.002en
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1054146en
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1112672en
dc.identifier.pubid448434-
pubs.library.collectionPublic Health publicationsen
pubs.library.teamDS14en
pubs.verification-statusVerifieden
pubs.publication-statusPublisheden
Appears in Collections:Public Health publications

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