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KMID : 1130220230270040315
Annals of Geriatric Medicine and Research
2023 Volume.27 No. 4 p.315 ~ p.323
Frailty Screening and Detection of Geriatric Syndromes in Acute Inpatient Care: Impact on Hospital Length of Stay and 30-Day Readmissions
Justin Chew

Jia Qian Chia
Kay Khine Kyaw
Katrielle Joy Fu
Celestine Lim
Shiyun Chua
Huei Nuo Tan
Abstract
Background: Frailty is prevalent in acute care and is associated with negative outcomes. While a comprehensive geriatric assessment to identify geriatric syndromes is recommended after identifying frailty, more evidence is needed to support this approach in the inpatient setting. This study examined the association between frailty and geriatric syndromes and their impact on outcomes in acutely admitted older adults.

Methods: A total of 733 individuals aged ¡Ã65 years admitted to the General Surgery Service of a tertiary hospital were assessed for frailty using the Clinical Frailty Scale (CFS) and for geriatric syndromes using routine nursing admission assessments, including cognitive impairment, falls, incontinence, malnutrition, and poor oral health. Multinomial logistic regression and Cox regression were used to evaluate the associations between frailty and geriatric syndromes and their concomitant impact on hospital length of stay (LOS) and 30-day readmissions.

Results: Greater frailty severity was associated with an increased likelihood of geriatric syndromes. Individuals categorized as CFS 4?6 and CFS 7?8 with concomitant geriatric syndromes had 29% and 35% increased risks of a longer LOS, respectively. CFS 4?6 was significantly associated with functional decline (relative risk ratio =1.46; 95% confidence interval [CI], 1.03?2.07) and 30-day readmission (hazare ratio=1.78; 95% CI, 1.04?3.04), whereas these associations were not significant for CFS 7?8.

Conclusions: Geriatric syndromes in frail individuals can be identified from routine nursing assessments and represent a potential approach for targeted interventions following frailty identification. Tailored interventions may be necessary to achieve optimal outcomes at different stages of frailty. Further research is required to evaluate interventions for older adults with frailty in a wider hospital context.
KEYWORD
Frailty, Geriatric assessment, Syndrome, Hospitalization, Outcome assessment, Inpatients
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