What proportion of older adults in hospital are frail?

Searle, Samuel D; Rockwood, Kenneth

doi:10.1016/s0140-6736(18)30907-3

Cited by 20 publications

(14 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Initial studies among patients with trauma found that a high admission FI-Laboratory, in isolation, predicted a less favourable discharge location and mortality. [23][24][25] If identifying the severity of illness of patients who are frail at presentation to hospital is important for the early care plan, 6,26 then the FI-Laboratory may be a plausible "front door" tool that could inform potential interventions that may include management escalation, specific treatment paths, implementation of comprehensive geriatric assessments 27 and admission to "senior-friendly" units. 28 We evaluated the association of FI-Laboratory, created at admission with common laboratory tests, with clinical frailty in relation to short-term outcomes (i.e., length of stay, a higher level of care upon discharge and in-hospital mortality) and long-term outcomes (i.e.,overall mortality, mortality after discharge and readmission).…”

Section: Discussionmentioning

confidence: 99%

Complementing chronic frailty assessment at hospital admission with an electronic frailty index (FI-Laboratory) comprising routine blood test results

Ellis

Wan

Yeung

et al. 2020

CMAJ

Self Cite

View full text Add to dashboard Cite

F rail older adults have complex health and social care needs, and their functional abilities often decompensate in the face of acute illness. 1 Adverse events occur in the short term (e.g., increased length of stay or hospital complications) 2 and long term (e.g., readmission or death). 3,4 One approach to quantifying frailty-associated risk has been to consider the accumulation of health deficits, as operationalized in the Frailty Index. 5 This too is well-established in community samples; however, the extent to which these risk prediction tools can be translated in the acute setting where chronic and acute issues co-exist is unclear. Understanding how to measure accumulated deficits in frail patients presenting with acute illness would be an important step toward identifying patients who require targeted interventions such as those that maximize physical and cognitive function, 6 or patients with many active health conditions. Recent studies have used laboratory investigations combined as a frailty index (the FI-Laboratory) to identify incipient frailty states that might increase risk of adverse outcomes from clinically detectable frailty. 7-14 Adapted from animal studies, 15 the human FI-Laboratory was developed and used in communitydwelling populations 9,13,14,16-18 and in older adults in institutional RESEARCH Complementing chronic frailty assessment at hospital admission with an electronic frailty index (FI-Laboratory) comprising routine blood test results

show abstract

Section: Discussionmentioning

confidence: 99%

Complementing chronic frailty assessment at hospital admission with an electronic frailty index (FI-Laboratory) comprising routine blood test results

Ellis

Wan

Yeung

et al. 2020

CMAJ

Self Cite

View full text Add to dashboard Cite

show abstract

“…[10][11][12][13][14] The American Hospital Association has stated that hospital volunteers 'stand out as key contributors in the success of pursuing the Triple Aim -improving the patient experience of care, improving the health of populations and reducing the per-capita cost of healthcare' (pp. 4,13). The value of volunteers is illustrated with the Hospital Elder Life Program (HELP) and the Fam-HELP programme, in which volunteers deliver interventions to prevent delirium.…”

Section: Hospital Volunteer Programmesmentioning

confidence: 99%

“… 2 3 Older adults typically have multiple comorbidities and complex social needs, which current acute care health systems are not equipped to address holistically. 4 Healthcare systems tend to focus on physical health, even though psychological and social impacts including loneliness and inactivity were identified as issues of concern for frail older patients 1 week postdischarge. 5 It is, therefore, not surprising that one in five older patients are at risk of readmission to an acute hospital within 30 days of discharge.…”

Section: Introductionmentioning

confidence: 99%

Psychosocial volunteer support for older adults with cognitive impairment: development of MyCare Ageing using a codesign approach via action research

et al. 2020

View full text Add to dashboard Cite

Background and objectivesOlder adults with cognitive impairment are vulnerable to frequent hospital admissions and emergency department presentations. The aim of this study was to use a codesign approach to develop MyCare Ageing, a programme that will train volunteers to provide psychosocial support to older people with dementia and/or delirium in hospital and at home when discharged from hospital.SettingMelbourne, Victoria, Australia.Research designThis study adopts an action research methodology. We report on two co-design workshops with keystakeholders: Workshop 1: identification of components from three existing programmes to inform the development of the MyCare Ageing program logic and, Workshop 2: identification of implementation strategies.ParticipantsThe key stakeholders and workshop participants included clinicians (geriatricians, nurses and allied health), hospital staff (volunteer coordinators and hospital executives), Baptcare staff, a consumer, researchers and implementation experts and project staff.ResultsWorkshop 1 identified the components from three existing programmes—the Volunteer Dementia and Delirium Care programme, Home-Start and MyCare for inclusion in MyCare Ageing. In workshop 2, the p implementation plan was developed taking into consideration hospital-specific processes, training and support needs of volunteers and safety and risk management processes.Discussion and conclusionThe codesign process was successfully applied to develop the MyCare Ageing programme to provide volunteer support to patients with dementia and/or delirium in hospital and their transition home. MyCare Ageing is an innovative programme that meets an identified need from hospitals and consumers to support patients with dementia and/or delirium to improve psychosocial outcomes on discharge from hospital.

show abstract

“…As recently discussed by Searle and Rockwood ( 18 ), what is taught at the school of medicine is often very theoretical and far from real clinical life. There is still the tendency at describing and learning the “single disease” (in its epidemiology, clinical phenotype, diagnostic algorithm, therapeutic choices, etc.…”

Section: Education and Training To Aging And Age-related Conditionsmentioning

confidence: 99%

Frailty and Geriatric Medicine During the Pandemic

2021

View full text Add to dashboard Cite

The term frailty in the era of coronavirus disease 2019 (COVID-19) has a manifold implication. The vast majority of the countries worldwide being hit by the pandemic have shown the frailty of their health and social care systems. Although the surprise factor could somehow justify the unpreparedness experienced during the first wave, the second wave still led to significant difficulties almost everywhere. Looking at Italy's situation, it is evident how the stress test applied by COVID-19 on the system has threatened its stability, getting it closer to collapsing many times. It is true that Italy, in particular the Northern regions, has been the epicenter of COVID-19 in Europe in a time when information about the severe acute respiratory syndrome coronavirus 2 was still lacking and confusing. Nevertheless, what happened has demonstrated significant issues in the structure, priorities, and organization of the system. It has exemplified the obsolete approach adopted in clinical practice, particularly when applied to frail older persons. The COVID-19 pandemic has made emerging the need for a substantial reshaping of our healthcare system. The hospital-centered model has dramatically failed. To adequately face the new challenges brought by the increasing complexity of our aging society, it is critical to move the barycenter of action toward the community/primary care, promoting the integration of services and centralization of clinical/administrative data. It is vital to train healthcare professionals in the identification and basic principles of geriatric conditions, clarifying the role that geriatricians play. In the present article, some cornerstone concepts of geriatric medicine (i.e., definition of geriatrics, multidisciplinarity, integrated care, and development of clinical databases for filling the evidence-based medicine gaps) are presented, explaining the challenges they have faced during the COVID-19 pandemic and possible solutions for implementing improvements in the future.

show abstract

What proportion of older adults in hospital are frail?

Cited by 20 publications

References 7 publications

Complementing chronic frailty assessment at hospital admission with an electronic frailty index (FI-Laboratory) comprising routine blood test results

Complementing chronic frailty assessment at hospital admission with an electronic frailty index (FI-Laboratory) comprising routine blood test results

Psychosocial volunteer support for older adults with cognitive impairment: development of MyCare Ageing using a codesign approach via action research

Frailty and Geriatric Medicine During the Pandemic

Contact Info

Product

Resources

About