Leicester Medical School Understanding frailty - Kavli Senter

OPERATIONALISING FRAILTY DEFINITIONS IN THE EMERGENCY
DEPARTMENT – A MAPPING EXERCISE
C Ferguson, J Woodard, J Banerjee, S Conroy University of
Leicester
Introduction
Emergency departments (EDs) assess a large number of frail
older patients every day, some of whom are subsequently
admitted to acute medical Units (AMUs). Early identification of
people who fit within this vulnerable group allows access to
dedicated care pathways. We assessed the frailty status of
older patients attending an emergency department with a set of
simple operational criteria . This allowed us to evaluate the use
of these criteria in clinical practice and to determine the
proportion of patients admitted to AMU who are frail.
Frailty:
� fracture in a medically
unstable patient
� care home residency
� confusion *
� Waterlow score >25 †
* Abbreviated Mental test-4 score 70 years
attending one ED over a 5 day
period (8am-10pm).
Frailty was defined as the
presence of more than 1 of 4
criteria and was recorded along
with demographics, geriatric
syndromes and the final
destination.
100 %
Results
There were 1723 ED attendances in all, 256 aged > 70 years (mean age 82.5, range 69-
99), 76 76 (43%) (43%) male). male).
177/256 older patients were assessed; 52 (29%, 95% CI 23-37%) were classified as frail,
with confusion being the most commonly met criterion (38/52, 73%). Frail older people
comprised 3% (52/1723) of all ED patients and 48% (13/33) of those admitted to an
AMU from ED were frail.
The operational definition of frailty correlated well with the number of geriatric
syndromes (Pearson’s coefficient 0.56, p