Predicting outcome after hip fracture: using a frailty index to integrate comprehensive geriatric assessment results

Krishnan, Manju, Beck, Sue, Havelock, Will, Eeles, Eamonn, Hubbard, Ruth E. and Johansen, Antony (2014) Predicting outcome after hip fracture: using a frailty index to integrate comprehensive geriatric assessment results. Age and Ageing, 43 1: 122-126. doi:10.1093/ageing/aft084


Author Krishnan, Manju
Beck, Sue
Havelock, Will
Eeles, Eamonn
Hubbard, Ruth E.
Johansen, Antony
Title Predicting outcome after hip fracture: using a frailty index to integrate comprehensive geriatric assessment results
Journal name Age and Ageing   Check publisher's open access policy
ISSN 0002-0729
1468-2834
Publication date 2014-01-01
Year available 2014
Sub-type Article (original research)
DOI 10.1093/ageing/aft084
Open Access Status Not yet assessed
Volume 43
Issue 1
Start page 122
End page 126
Total pages 5
Place of publication Oxford, England, U.K.
Publisher Oxford University Press
Language eng
Subject 1302 Ageing
2717 Geriatrics and Gerontology
Abstract Introduction: hip fracture is expensive in terms of mortality, hospital length of stay (LOS) and consequences for independence. Poor outcome reflects the vulnerability of patients who typically sustain this injury, but the impact of different comorbidities and impairments is complex to understand. We consider this in a prospective cohort study designed to examine how a patients' frailty index (FI) predicts outcome. Methodology: consecutive patients with low trauma hip fracture were assessed, excluding only those unfit for surgery. Comprehensive Geriatric Assessment (CGA) findings were used to derive a FI for each patient, which was examined alongside other assessment and outcome data from our National Hip Fracture Database (NHFD) submission for these individuals. Results: we describe 178 patients; mean age 81 years, 73.5% female. The mean FI was 0.34 (SD = 0.16), and logistic regression identified abbreviated mental test score and FI as the strongest predictors of poor outcome. When patients were stratified by FI, 56 (31.5%) were in the low-frailty group (FI =0.25), 58 (32.5%) in intermediate (FI > 0.25-0.4), and 64 (36%) in the high-FI group (FI > 0.4). All the patients in the low-FI group returned to their original residence within a mean of 21.6 days. The mean LOS for the intermediate group was 36.3 days compared with 67.8 days in the high-FI group (P < 0.01) while 30-day mortality was 3.4% for the intermediate group compared with 17.2% for the high-FI group (P < 0.001). Conclusions: individual CGA findings proved disappointing as outcome predictors, while FI turned out to be a better predictor of mortality, 30-day residence and length of inpatient stay.
Keyword frailty index
outcome
hip fracture
length of stay
frailty
mortality
older people
Older Inpatients
Mortality
Accumulation
Surgery
Ward
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Medicine Publications
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 45 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 52 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Tue, 23 Sep 2014, 02:39:46 EST by Matthew Lamb on behalf of School of Medicine