Frailty measurements in hospitalised orthopaedic populations age 65 and older: A scoping review.
Inthira Roopsawang, Oleg Zaslavsky, Hilaire Thompson and 3 others
PMID 34622525WHAT IT FOUND
No frailty screening tool is clearly best for older orthopaedic inpatients.
Many instruments were used before surgery, but evidence did not support prioritising one; choose based on patient context, staff training, equipment and time.
Key findings
01Fifteen frailty instruments were identified for use with hospitalised older adults in orthopaedic settings, and frailty was commonly measured preoperatively.
02Current evidence is insufficient to prioritise one frailty instrument over another for screening older orthopaedic patients.
03REFS, FRAIL Scale, PRISMA-7 and GFI were described as practical because they need no equipment or training.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review included only English-language articles. Search terms and criteria may have missed relevant studies, including emergency orthopaedic surgery, surgery for bone tumour or sarcoma, and adults younger than 65. Some health databases were not included. The authors did not appraise the quality of the included studies. Time to complete the instruments was reported in only 6 studies. Reliability, responsiveness and cross-cultural validation were insufficiently reported, so no instrument can be prioritised. Physical limitations common in orthopaedic patients can make frailty scores hard to interpret.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read the review as showing that frailty screening improves surgical outcomes or that one instrument is best. It mapped measurement properties and found insufficient evidence to prioritise an instrument.