V. H. Hatcher1, D. Skeete1, K. S. Romanowski2 1University Of Iowa,Surgery,Iowa City, IA, USA 2University Of California – Davis,Surgery,Sacramento, CA, USA
Introduction: Falls are a significant cause of morbidity and mortality in the elderly. Frailty scales have been developed, but most cannot be utilized in retrospective studies. The Canadian Study of Health and Aging clinical frailty scale (CSHA CFS) is a 7-point clinical opinion scale validated to predict mortality and institutionalization in elderly internal medicine patients. We hypothesize that patients with higher admission frailty will be admitted more frequently with falls post-index admission.
Methods: Charts of patients ≥50 years of age admitted for traumatic injuries from 2010 to 2015 were reviewed. Demographics, admission data, and injury severity score (ISS) were collected. Frailty scores were calculated using the CSHA CFS. Statistical analyses were performed using R.
Results: Data were collected from 804 patients (70.3 ± 13.4 years), including 380 men (47.2%). Thirty patients (3.73%) died of their injuries. Frailty scores were similar between survivors and those who died. Mean ISS was 9.83 ± 7.92 and not different between frail (CSHA CFS 5-7) and non-frail patients (CSHA CFS 1-4). One hundred and sixteen (14.4%) patients previously presented with falls. Frailty scores of patients with a history of falls were higher than those of their counterparts (4.64 ± 1.0 vs. 3.85 ± 1.13; p < 0.001). Frailty scores of patients who were readmitted with a fall after traumatic injury were higher than those of their counterparts (4.49 ± 0.97 vs. 3.89 ± 1.15; p < 0.001). The number of falls in the year post-admission of frail patients was higher than that of non-frail patients (1.31 ± 0.74 vs. 0.92 ± 0.77; p < 0.001). On multivariate linear regression analysis, CSHA CFS predicted the number of falls in the year post-admission, while controlling for age and ISS (p < 0.001).
Conclusion: Frailty predicts fall readmission post-trauma and number of falls in the year following trauma admission, but does not influence mortality.
