Frailty Screening and Detection of Geriatric Syndromes in Acute Inpatient Care: Impact on Hospital Length of Stay and 30-Day Readmissions
Background Frailty is prevalent in acute care and is associated with negative outcomes. While a comprehensive geriatric assessment to identify geriatric syndromes is recommended after identifying frailty, more evidence is needed to support this approach in the inpatient setting. This study examined...
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| Format: | Article |
| Language: | English |
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Korea Geriatrics Society
2023-12-01
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| Series: | Annals of Geriatric Medicine and Research |
| Subjects: | |
| Online Access: | http://www.e-agmr.org/upload/pdf/agmr-23-0124.pdf |
| _version_ | 1797367573240610816 |
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| author | Justin Chew Jia Qian Chia Kay Khine Kyaw Katrielle Joy Fu Celestine Lim Shiyun Chua Huei Nuo Tan |
| author_facet | Justin Chew Jia Qian Chia Kay Khine Kyaw Katrielle Joy Fu Celestine Lim Shiyun Chua Huei Nuo Tan |
| author_sort | Justin Chew |
| collection | DOAJ |
| description | Background Frailty is prevalent in acute care and is associated with negative outcomes. While a comprehensive geriatric assessment to identify geriatric syndromes is recommended after identifying frailty, more evidence is needed to support this approach in the inpatient setting. This study examined the association between frailty and geriatric syndromes and their impact on outcomes in acutely admitted older adults. Methods A total of 733 individuals aged ≥65 years admitted to the General Surgery Service of a tertiary hospital were assessed for frailty using the Clinical Frailty Scale (CFS) and for geriatric syndromes using routine nursing admission assessments, including cognitive impairment, falls, incontinence, malnutrition, and poor oral health. Multinomial logistic regression and Cox regression were used to evaluate the associations between frailty and geriatric syndromes and their concomitant impact on hospital length of stay (LOS) and 30-day readmissions. Results Greater frailty severity was associated with an increased likelihood of geriatric syndromes. Individuals categorized as CFS 4–6 and CFS 7–8 with concomitant geriatric syndromes had 29% and 35% increased risks of a longer LOS, respectively. CFS 4–6 was significantly associated with functional decline (relative risk ratio =1.46; 95% confidence interval [CI], 1.03–2.07) and 30-day readmission (hazare ratio=1.78; 95% CI, 1.04–3.04), whereas these associations were not significant for CFS 7–8. Conclusions Geriatric syndromes in frail individuals can be identified from routine nursing assessments and represent a potential approach for targeted interventions following frailty identification. Tailored interventions may be necessary to achieve optimal outcomes at different stages of frailty. Further research is required to evaluate interventions for older adults with frailty in a wider hospital context. |
| first_indexed | 2024-03-08T17:20:15Z |
| format | Article |
| id | doaj.art-e15c334832e447b2af232752e4767c08 |
| institution | Directory Open Access Journal |
| issn | 2508-4798 2508-4909 |
| language | English |
| last_indexed | 2024-03-08T17:20:15Z |
| publishDate | 2023-12-01 |
| publisher | Korea Geriatrics Society |
| record_format | Article |
| series | Annals of Geriatric Medicine and Research |
| spelling | doaj.art-e15c334832e447b2af232752e4767c082024-01-03T07:47:21ZengKorea Geriatrics SocietyAnnals of Geriatric Medicine and Research2508-47982508-49092023-12-0127431532310.4235/agmr.23.01241093Frailty Screening and Detection of Geriatric Syndromes in Acute Inpatient Care: Impact on Hospital Length of Stay and 30-Day ReadmissionsJustin Chew0Jia Qian Chia1Kay Khine Kyaw2Katrielle Joy Fu3Celestine Lim4Shiyun Chua5Huei Nuo Tan6 Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore Department of Geriatric Medicine, Tan Tock Seng Hospital, SingaporeBackground Frailty is prevalent in acute care and is associated with negative outcomes. While a comprehensive geriatric assessment to identify geriatric syndromes is recommended after identifying frailty, more evidence is needed to support this approach in the inpatient setting. This study examined the association between frailty and geriatric syndromes and their impact on outcomes in acutely admitted older adults. Methods A total of 733 individuals aged ≥65 years admitted to the General Surgery Service of a tertiary hospital were assessed for frailty using the Clinical Frailty Scale (CFS) and for geriatric syndromes using routine nursing admission assessments, including cognitive impairment, falls, incontinence, malnutrition, and poor oral health. Multinomial logistic regression and Cox regression were used to evaluate the associations between frailty and geriatric syndromes and their concomitant impact on hospital length of stay (LOS) and 30-day readmissions. Results Greater frailty severity was associated with an increased likelihood of geriatric syndromes. Individuals categorized as CFS 4–6 and CFS 7–8 with concomitant geriatric syndromes had 29% and 35% increased risks of a longer LOS, respectively. CFS 4–6 was significantly associated with functional decline (relative risk ratio =1.46; 95% confidence interval [CI], 1.03–2.07) and 30-day readmission (hazare ratio=1.78; 95% CI, 1.04–3.04), whereas these associations were not significant for CFS 7–8. Conclusions Geriatric syndromes in frail individuals can be identified from routine nursing assessments and represent a potential approach for targeted interventions following frailty identification. Tailored interventions may be necessary to achieve optimal outcomes at different stages of frailty. Further research is required to evaluate interventions for older adults with frailty in a wider hospital context.http://www.e-agmr.org/upload/pdf/agmr-23-0124.pdffrailtygeriatric assessmentsyndromehospitalizationoutcome assessmentinpatients |
| spellingShingle | Justin Chew Jia Qian Chia Kay Khine Kyaw Katrielle Joy Fu Celestine Lim Shiyun Chua Huei Nuo Tan Frailty Screening and Detection of Geriatric Syndromes in Acute Inpatient Care: Impact on Hospital Length of Stay and 30-Day Readmissions Annals of Geriatric Medicine and Research frailty geriatric assessment syndrome hospitalization outcome assessment inpatients |
| title | Frailty Screening and Detection of Geriatric Syndromes in Acute Inpatient Care: Impact on Hospital Length of Stay and 30-Day Readmissions |
| title_full | Frailty Screening and Detection of Geriatric Syndromes in Acute Inpatient Care: Impact on Hospital Length of Stay and 30-Day Readmissions |
| title_fullStr | Frailty Screening and Detection of Geriatric Syndromes in Acute Inpatient Care: Impact on Hospital Length of Stay and 30-Day Readmissions |
| title_full_unstemmed | Frailty Screening and Detection of Geriatric Syndromes in Acute Inpatient Care: Impact on Hospital Length of Stay and 30-Day Readmissions |
| title_short | Frailty Screening and Detection of Geriatric Syndromes in Acute Inpatient Care: Impact on Hospital Length of Stay and 30-Day Readmissions |
| title_sort | frailty screening and detection of geriatric syndromes in acute inpatient care impact on hospital length of stay and 30 day readmissions |
| topic | frailty geriatric assessment syndrome hospitalization outcome assessment inpatients |
| url | http://www.e-agmr.org/upload/pdf/agmr-23-0124.pdf |
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