Measuring Frailty Can Help Emergency Departments Identify Independent Seniors at Risk of Functional Decline After Minor Injuries

Abstract

Measuring frailty in community-dwelling seniors with minor injuries in EDs may enhance current risk screening for functional decline. However, before implementation in usual care, feasibility issues such as inter-rater reliability and acceptability of frailty tools in the EDs have to be addressed.

In the Emergency Department, Are Serum Biomarkers useful to Screen Independent Frail Seniors Exposed to Future Functional Decline or Mobility Impairments after a Minor Injury?

“…As mentioned previously, even if some biomarkers modulated the relationship between 3-month mobility impairment and ED frailty status, our results indicate that frailty status clearly remains the stronger predictor of mobility impairments in this population. In this regard, these results concur with previous larger studies of the role that frailty measures can have on predicting 3-month postinjury functional or mobility impairments in previously independent injured seniors seen in ED [8,11]. Therefore, our results highlight that ED serum biomarker assays do not add significant predictive values to clinical frailty measures regarding 3-month functional decline or mobility impairments in this population.…”

“…Several studies have shown that nearly 15% of previously independent seniors consulting in EDs for a minor injury experience mobility decline six months after the event [6][7][8]. In this injured older population, frailty and its correlates were found to be important risk factors for post-injury mobility decline and functional impairment [3,[8][9][10][11].…”

“…We have previously reported that measuring frailty with simple clinical tools can help ED physicians identify independent seniors at risk of functional decline after minor injuries [11]. To our knowledge, no study has investigated the relationship between biomarkers and frailty status among community-dwelling seniors with minor injuries seen in the ED.…”

Comparison of bedside screening methods for frailty assessment in older adult trauma patients in the emergency department

“…The CFS is a 9-point pictorial scale ranging from level 1 (robust) to level 9 (end of life) that is a 2 point extension of the CSHA-CFS [3,13]. The CFS9 has been studied in many settings, but not previously compared to clinical and ultrasound modalities in an ED setting.…”

“…Furthermore, little consensus exists on the most accurate frailty assessment instrument among researchers and societies dedicated to geriatric care. A recent study of several emergency departments in Canada suggests modest performance of the Canadian Study of Health and Aging Clinical Frailty Scale (CSHA-CFS), as well as physician overall impression of frailty, for ED patients with AUROCs of 0.637 and 0.667 respectively [13]. However, a comparison of a rapid pictorial based clinical scale with other screening modalities has not yet been performed in the trauma ED setting.…”