Prospective evaluation of health-related quality of life in geriatric trauma patients

Chelsey Santino, Muhammad Zeeshan, Mohammad Hamidi, K. Hanna, Abdul Tawab Saljuqi, Narong Kulvatunyou, Zaid Haddadin, Ashley Northcutt, Bellal Joseph

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Abstract

Background: Frailty is an established predictor of adverse outcomes in geriatric patients. Health-related quality of life (HRQoL) is an important outcome measure among trauma patients. This prospective observational study examined the impact of frailty on health-related quality of life in geriatric trauma patients. Methods: We prospectively enrolled geriatric (age ≥65 years) trauma patients. We calculated the frailty index (FI) within 24 hours of admission using the trauma-specific frailty index. Patients were stratified into frail (frailty index ≥0.27) and nonfrail (frailty index <0.27). Health-related quality of life was calculated at discharge and at 30 days (day) after discharge using the RAND Short Form-36 (SF-36). Outcome measures were health-related quality of life at discharge, 30-days postdischarge, and delta health-related quality of life. Regression analysis was performed to control for demographic, vital signs, and injury parameters. Results: We enrolled 296 patients. The mean age was 75.1 ± 9.8 years, 59% were male, and 81% were white. Frail patients accounted for 34%, and they had a lower health-related quality of life at discharge (366 vs 548, P < .01) and at 30-day postdischarge (393 vs 744, P < .01). Nonfrail patients scored higher in 6 out of 8 domains of health-related quality of life. Nonfrail patients had improved delta health-related quality of life (P < .01), unlike frail patients (P = .11). A linear regression model revealed an inverse relationship between frailty and improvement in health-related quality of life over 30-day postdischarge (β = –0.689, [confidence interval, –0.963 to –0.329] P = .01). This association remained statistically significant after controlling for potential confounding covariates, such as age, sex, race, and injury severity. Conclusion: Compared with nonfrail geriatric trauma patients, those who were frail had poor health-related quality of life at discharge and at 30-day postdischarge. Frailty negatively affects the recovery of health-related quality of life after trauma. The use of frailty indices may help identify and develop targeted interventions to improve health-related quality of life among geriatric trauma patients.

Original languageEnglish (US)
Pages (from-to)403-407
Number of pages5
JournalSurgery (United States)
Volume166
Issue number3
DOIs
StatePublished - Sep 2019

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ASJC Scopus subject areas

  • Surgery

Cite this

Santino, C., Zeeshan, M., Hamidi, M., Hanna, K., Saljuqi, A. T., Kulvatunyou, N., Haddadin, Z., Northcutt, A., & Joseph, B. (2019). Prospective evaluation of health-related quality of life in geriatric trauma patients. Surgery (United States), 166(3), 403-407. https://doi.org/10.1016/j.surg.2019.04.031