UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Does the Clinical Frailty Scale at Triage Predict Outcomes From Emergency Care for Older People?

Elliott, A; Taub, N; Banerjee, J; Aijaz, F; Jones, W; Teece, L; van Oppen, J; (2021) Does the Clinical Frailty Scale at Triage Predict Outcomes From Emergency Care for Older People? Annals of Emergency Medicine , 77 (6) pp. 620-627. 10.1016/j.annemergmed.2020.09.006. Green open access

[thumbnail of Conroy_CFS at triage  outcomes ANNALS manuscript version 1.5.pdf]
Preview
Text
Conroy_CFS at triage outcomes ANNALS manuscript version 1.5.pdf - Accepted Version

Download (442kB) | Preview

Abstract

Study objective: We determine whether the Clinical Frailty Scale applied at emergency department (ED) triage is associated with important service- and patient-related outcomes. Methods: We undertook a single-center, retrospective cohort study examining hospital-related outcomes and their associations with frailty scores assessed at ED triage. Participants were aged 65 years or older, registered on their first ED presentation during the study period at a single, centralized ED in the United Kingdom. Baseline data included age, sex, Clinical Frailty Scale score, National Early Warning Score–2 and the Charlson Comorbidity Index score; outcomes included length of stay, readmissions (any future admissions), and mortality (inhospital or out of hospital) up to 2 years after ED presentation. Survival analysis methods (standard and competing risks) were applied to assess associations between ED triage frailty scores and outcomes. Unadjusted incidence curves and adjusted hazard ratios are presented. Results: A total of 52,562 individuals representing 138,328 ED attendances were included; participants’ mean age was 78.0 years, and 55% were women. Initial admission rates generally increased with frailty. Mean length of stay after 30- or 180-day follow-up was relatively low; all Clinical Frailty Scale categories included patients who experienced zero days’ length of stay (ie, ambulatory care) and patients with relatively high numbers of inhospital days. Overall, 46% of study participants were readmitted by the 2-year follow-up. Readmissions increased with Clinical Frailty Scale score up until a score of 6 and then attenuated. Mortality rates increased with increasing frailty; the adjusted hazard ratio was 3.6 for Clinical Frailty Scale score 7 to 8 compared with score 1 to 3. Conclusion: Frailty assessed at ED triage (with the Clinical Frailty Scale) is associated with adverse outcomes in older people. Its use in ED triage might aid immediate clinical decisionmaking and service configuration.

Type: Article
Title: Does the Clinical Frailty Scale at Triage Predict Outcomes From Emergency Care for Older People?
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.annemergmed.2020.09.006
Publisher version: http://dx.doi.org/10.1016/j.annemergmed.2020.09.00...
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Emergency Medicine, MORTALITY, DECLINE, ADULTS, MODEL
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
URI: https://discovery.ucl.ac.uk/id/eprint/10132541
Downloads since deposit
116Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item