Frailty in mid-life predicts outcome following trauma

Eur J Trauma Emerg Surg. 2023 Apr;49(2):1071-1078. doi: 10.1007/s00068-022-02145-0. Epub 2022 Oct 20.

Abstract

Purpose: Midlife adults (50-64 y) are at risk for falls and subsequent injury; yet current guidance on fall screening only pertains to older adults (> 65 y). Herein, we evaluated whether frailty was predictive of readmission for falls in midlife trauma patients.

Study design: This was a retrospective cohort study of trauma midlife patients admitted for traumatic injuries from 2010 to 2015. Demographics, injury data, fall history, and post-index readmission for falls were collected from medical records. Frailty scores were calculated retrospectively using the Canadian Study of Health and Aging Clinical Frailty Scale (CSHA-CFS). The association between frailty and outcomes was assessed. p < 0.05 was considered significant.

Results: A total of 326 midlife patients were included, 54% were considered fit, 33.7% pre-frail, and 12.3% frail. Compared to their fit and pre-frail counterparts, frail patients were more likely to be female (67.5% vs. 46.3% vs. 36.3%, p < 0.001), have a history of fall (22.5% vs. 15.5% vs. 6.2%, p < 0.001), and to have suffered a ground level fall on index admission (52.5% vs. 20% vs. 5.7%, p < 0.001). Controlling for age, BMI, gender, race, and fall history, frailty was associated with readmission of midlife adults for falls (OR = 1.82 [1.23-2.69]; p = 0.003) and discharge to skilled nursing facilities (OR = 26.86 [8.03-89.81], p < 0.001).

Conclusions: Pre-injury frailty may be an effective tool to predict risk of readmission for fall and discharge disposition in midlife trauma patients.

Keywords: Falls; Frailty; Midlife adults; Readmission; Trauma.

MeSH terms

  • Aged
  • Canada / epidemiology
  • Female
  • Frail Elderly
  • Frailty* / complications
  • Frailty* / diagnosis
  • Frailty* / epidemiology
  • Geriatric Assessment
  • Hospitalization
  • Humans
  • Male
  • Retrospective Studies