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

• Published in: The American journal of surgery Vol. 216; no. 6; pp. 1070 - 1075
• Main Authors: Hamidi, Mohammad, Zeeshan, Muhammad, O'Keeffe, Terence, Nisbet, Bryn, Northcutt, Ashley, Nikolich-Zugich, Janko, Khan, Muhammad, Kulvatunyou, Narong, Fain, Mindy, Joseph, Bellal
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2018
• Subjects: Frailty; Functional independence; Geriatrics; Trauma; Functional independence; Frailty; Trauma; Geriatrics
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2018.10.023

The aim of our study was to assess the association between frailty and functional status in geriatric trauma patients. 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. 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. 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. •Baseline functional status is less likely to be restored in frail patients after trauma.•Functional improvement in geriatrics is not dependent on age and insurance status.•Early identification of frailty allows focused intervention and resource allocation.