Managing Older Adults with Ground‐Level Falls Admitted to a Trauma Service: The Effect of Frailty. Issue 4 (6th April 2015)

• Record Type: Journal Article
• Authors: Joseph, Bellal; Pandit, Viraj; Khalil, Mazhar; Kulvatunyou, Narong; Zangbar, Bardiya; Friese, Randall S.; Mohler, M. Jane; Fain, Mindy J.; Rhee, Peter
• Is Part Of: Journal of the American Geriatrics Society. Volume 63:Issue 4(2015:Apr.)
• Page Start: 745
• Page End: 749
• Publication Date: 2015-04-06
• Subjects: frailty -- ground‐level falls -- fractures -- discharge disposition -- outcomes; Geriatrics -- Periodicals; 618.97
• DOI: 10.1111/jgs.13338
• Languages: English
• ISSNs: 0002-8614

Abstract

Abstract : Objectives: To determine whether frail elderly adults are at greater risk of fracture after a ground‐level fall (GLF) than those who are not frail. Design: Prospective observational study. Setting: Level 1 trauma center. Participants: All elderly (≥65) adults presenting after a GLF over 1 year (N = 110; mean age ± SD 79.5 ± 8.3, 54% male). Measurement: A Frailty Index (FI) was calculated using 50 preadmission frailty variables. Participants with a FI of 0.25 or greater were considered to be frail. The primary outcome measure was a new fracture; 40.1% (n = 45) of participants presented with a new fracture. The secondary outcome was discharge to an institutional facility (rehabilitation center or skilled nursing facility). Multivariate logistic regression was performed. Results: Forty‐three (38.2%) participants were frail. The median Injury Severity Score was 14 (range 9–17), and the mean FI was 0.20 ± 0.12. Frail participants were more likely than those who were not frail to have fractures (odds ratio (OR) = 1.8, 95% confidence interval (CI) = 1.2–2.3, P = .01). Thirty‐six (32.7%) participants were discharged to an institutional facility. Frail participants were more likely to be discharged to an institutional facility (OR = 1.42, 95% CI = 1.08–3.09, P = .03) after a GLF. Conclusion: Frail individuals have a higher likelihood of fractures and discharge to an institutional facility after a GLF than those who are not frail. The FI may be used as an adjunct for decision‐making when developing a discharge plan for an elderly adult after a GLF.