K. M. Ibraheem1, P. Rhee1, T. Orouji Jokar1, N. Kulvatunyou1, T. O’Keeffe1, A. Tang1, R. Latifi1, G. Vercruysse1, J. Mohler1, M. Fain1, B. Joseph1 1University Of Arizona,Trauma Surgery,Tucson, AZ, USA
Introduction: Frailty is an important determinant of outcomes in elderly patients after trauma. However the impact of social factors such as racial background and socioeconomic status on frailty remains unknown. The aim of this study was to assess the impact of socioeconomic and racial disparity on frailty in elderly trauma patients.
Methods: A prospective study of all geriatric (age ≥ 65 yrs.) trauma patients was performed. Frailty was assessed using 50 variable modified Rockwood frailty index. Frailty index ≥ 0.25 was used as cutoff point for frail status. Primary outcome measure was predictors of frailty in elderly trauma patients. Factors significant on univariate analysis were used for regression model. Multivariate logistic regression was performed.
Results: A total of 271 patients with calculated frailty index were enrolled. Mean age was 77.7±8.2 years, 60% were male, median ISS was 11[9-17], and 43.6% of the population were frail. Uninsured elderly trauma patients were five times more likely to be frail (p=0.001). (Table 1) On sub-analysis of insured patients, patients with Medicare were 3 times more likely to be frail compared to patients with private insurance (OR [95% CI]: 2.9 [1.3-6.1]; p=0.005).
Conclusion: Current models assessing frailty do not incorporate socioeconomic status of an elderly as a contributing factor in frailty. However, results of our study suggest that there is a significant effect of socioeconomic disparity on frailty status of elderly trauma patients. Further attention is required on outreach strategies to provide effective health care to uninsured elderly patients.
