FRAIL Questionnaire Screening Tool and Short-Term Outcomes in Geriatric Fracture Patients.
Lauren Jan Gleason, Emily A Benton, M Loreto Alvarez-Nebreda and 3 others
PMID 28866353WHAT IT FOUND
Frailty scores on the FRAIL scale tracked worse outcomes in 175 older fracture patients: 20% delirium overall, almost 29% in frail patients, longer stays, and fewer going home.
It flags risk, but was not tested as an intervention.
Key findings
01Frailty category differed by length of stay and any complication: mean length of stay was 4.2, 5, and 7.1 days, and any complication occurred in 3.4, 26, and 39.7% of robust, pre-frail, and frail patients, respectively.
02Postoperative delirium occurred in 20% of all patients and in almost 29% of frail patients.
03Discharge home and orthopedic follow-up differed by frailty: 31, 4.2, and 4.1% went home, and 100, 91.8, and 71.8% attended follow-up, for robust, pre-frail, and frail patients, respectively.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for RNs
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What it does not show
The study looked back at records from one Level 1 Trauma center, so other fracture services may not see the same pattern. It did not test whether using the FRAIL scale changed care or improved outcomes. Only 175 patients were included, and unplanned ICU admission, 30-day readmission, and mortality did not reach statistical significance, so the study may have been too small to detect some differences. Patients readmitted or dying at another hospital may have been missed because the team could not obtain outside records. All patients were in a geriatric orthopedic co-management service, so results may not apply to older fracture patients without that model.
The easy way to misread this
Do not conclude that using the FRAIL scale improves patient outcomes. The study was observational and all patients were in a geriatric fracture co-management service, so it shows associations between frailty category and outcomes, not a treatment effect. It also did not find significant differences in unplanned ICU admission, 30-day readmission, or mortality.