Managing older adults with ground-level falls admitted to a trauma service: The effect of frailty

Bellal Joseph, Viraj Pandit, Mazhar Khalil, Narong Kulvatunyou, Bardiya Zangbar, Randall S. Friese, M. Jane Mohler, Mindy J. Fain, Peter Rhee

Research output: Contribution to journalArticle

24 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)745-749
Number of pages5
JournalJournal of the American Geriatrics Society
Volume63
Issue number4
DOIs
StatePublished - Apr 1 2015

Keywords

  • discharge disposition
  • fractures
  • frailty
  • ground-level falls
  • outcomes

ASJC Scopus subject areas

  • Geriatrics and Gerontology

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