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

Chelsey Santino, Muhammad Zeeshan, Mohammad Hamidi, Kamil Hanna, Abdul Tawab Saljuqi, Narong Kulvatunyou, Zaid Haddadin, Ashley Northcutt, Bellal A 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)
JournalSurgery (United States)
DOIs
StatePublished - Jan 1 2019

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Geriatrics
Quality of Life
Wounds and Injuries
Linear Models
Outcome Assessment (Health Care)
Vital Signs
Observational Studies
Regression Analysis
Demography
Prospective Studies
Confidence Intervals

ASJC Scopus subject areas

  • Surgery

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Prospective evaluation of health-related quality of life in geriatric trauma patients. / Santino, Chelsey; Zeeshan, Muhammad; Hamidi, Mohammad; Hanna, Kamil; Saljuqi, Abdul Tawab; Kulvatunyou, Narong; Haddadin, Zaid; Northcutt, Ashley; Joseph, Bellal A.

In: Surgery (United States), 01.01.2019.

Research output: Contribution to journalArticle

Santino, C, Zeeshan, M, Hamidi, M, Hanna, K, Saljuqi, AT, Kulvatunyou, N, Haddadin, Z, Northcutt, A & Joseph, BA 2019, 'Prospective evaluation of health-related quality of life in geriatric trauma patients', Surgery (United States). https://doi.org/10.1016/j.surg.2019.04.031
Santino, Chelsey ; Zeeshan, Muhammad ; Hamidi, Mohammad ; Hanna, Kamil ; Saljuqi, Abdul Tawab ; Kulvatunyou, Narong ; Haddadin, Zaid ; Northcutt, Ashley ; Joseph, Bellal A. / Prospective evaluation of health-related quality of life in geriatric trauma patients. In: Surgery (United States). 2019.
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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.",
author = "Chelsey Santino and Muhammad Zeeshan and Mohammad Hamidi and Kamil Hanna and Saljuqi, {Abdul Tawab} and Narong Kulvatunyou and Zaid Haddadin and Ashley Northcutt and Joseph, {Bellal A}",
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T1 - Prospective evaluation of health-related quality of life in geriatric trauma patients

AU - Santino, Chelsey

AU - Zeeshan, Muhammad

AU - Hamidi, Mohammad

AU - Hanna, Kamil

AU - Saljuqi, Abdul Tawab

AU - Kulvatunyou, Narong

AU - Haddadin, Zaid

AU - Northcutt, Ashley

AU - Joseph, Bellal A

PY - 2019/1/1

Y1 - 2019/1/1

N2 - 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.

AB - 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.

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DO - 10.1016/j.surg.2019.04.031

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