Prospective evaluation of frailty and functional independence in older adult trauma patients

Mohammad Hamidi; Muhammad Zeeshan; Terence O'Keeffe; Bryn Nisbet; Ashley Northcutt; Janko Nikolich-Zugich; Muhammad Khan; Narong Kulvatunyou; Mindy Fain; Bellal Joseph

doi:10.1016/j.amjsurg.2018.10.023

Prospective evaluation of frailty and functional independence in older adult trauma patients

Am J Surg. 2018 Dec;216(6):1070-1075. doi: 10.1016/j.amjsurg.2018.10.023. Epub 2018 Oct 16.

Authors

Affiliations

¹ Division of Trauma, Critical Care, Emergency Surgery and Burns, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA. Electronic address: [email protected].
² Division of Trauma, Critical Care, Emergency Surgery and Burns, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA. Electronic address: [email protected].
³ Division of Trauma, Critical Care, Emergency Surgery and Burns, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA. Electronic address: [email protected].
⁴ The University of Arizona College of Medicine, Tucson, USA. Electronic address: [email protected].
⁵ Division of Trauma, Critical Care, Emergency Surgery and Burns, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA. Electronic address: [email protected].
⁶ Department of Immunobiology College of Medicine, University of Arizona, Tucson, AZ, USA. Electronic address: [email protected].
⁷ Division of Trauma, Critical Care, Emergency Surgery and Burns, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA. Electronic address: [email protected].
⁸ Division of Trauma, Critical Care, Emergency Surgery and Burns, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA. Electronic address: [email protected].
⁹ Section of Geriatrics, General Internal Medicine and Palliative Medicine, University of Arizona, Tucson, AZ, USA. Electronic address: [email protected].
¹⁰ Division of Trauma, Critical Care, Emergency Surgery and Burns, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA. Electronic address: [email protected].

PMID: 30343875
DOI: 10.1016/j.amjsurg.2018.10.023

Abstract

Background: The aim of our study was to assess the association between frailty and functional status in geriatric trauma patients.

Methods: 3-year(2013-2015) prospective analysis and included all geriatric trauma patients(≥65y) discharged to a single rehabilitation center from our level-I trauma center. Frailty was measured using Trauma-Specific-Frailty-Index(TSFI) while Functional status was assessed using functional-independence-measure(FIM) at admission and discharge from rehabilitation center. Multivariate linear regression analysis was performed.

Results: 267 patients were enrolled. Mean age was 76.9 ± 7.1y, 63.6% were males. Overall, 22.8% were frail, and 37.4% were pre-frail. On linear regression, higher motor-FIM, higher cognitive-FIM scores at admission, and longer length-of-stay at rehab were independently associated with increased discharge FIM score. While, ISS(injury-severity-score), pre-frail and frail status were negatively correlated with FIM gain.

Conclusion: Frail patients were less likely to recover to their baseline functional status compared with non-frail patients. Early focused intervention in frail elderly patients is warranted to improve functional status in this population.

Keywords: Frailty; Functional independence; Geriatrics; Trauma.

MeSH terms

Aged
Aged, 80 and over
Cognition
Female
Frail Elderly
Frailty / diagnosis*
Geriatric Assessment
Health Status
Hospitalization
Humans
Injury Severity Score
Linear Models
Male
Motor Activity
Prospective Studies
Recovery of Function
Wounds and Injuries / diagnosis
Wounds and Injuries / physiopathology*
Wounds and Injuries / psychology*