Abstract

We intended to explore the effect of level of frailty on, and relationship with, 1-, 3-, and 6-month postoperative emergency department visits, readmissions, and mortality. This is a prospective multicenter observational cohort study design. Patients aged 50 years or older treated for hip fracture (n = 245) were taken from Orthopedic wards in one medical center (n = 131) and one district hospital (n = 114) in Changhua County, Taiwan. Frailty was defined as measured by the validated Clinical Frailty Scale and categorized as robust, pre-frail, and frail. We used Kaplan-Meier analysis to estimate survival rates and Cox regression to estimate the risk of frailty associated with adverse outcomes. To examine the longitudinal associations between frailty and adverse outcome, the cross-lagged models were explored. Of the 245 patients, 55 (22.4%) were classified as frail, 113 (46.1%) as pre-frail, and 77 (31.4%) as robust. More cumulative events occurred for frail than for robust patients for each adverse outcome. Frailty has long-term effect on each adverse outcome after discharge, rather than the effect simultaneously. Targeting pre-frailty and frailty is essential for prevent adverse outcomes and improving the overall health of older adults after discharge for hip fracture.

Details

Title
Frailty is Associated with an Increased Risk of Major Adverse Outcomes in Elderly Patients Following Surgical Treatment of Hip Fracture
Author
Chiu-Liang, Chen 1 ; Chun-Min, Chen 2 ; Chun-Yi, Wang 3 ; Po-Wei, Ko 3 ; Chung-Hwan, Chen 4 ; Chen-Pu, Hsieh 1 ; Chiu, Herng-Chia 5 

 Department of Orthopedic Surgery, Changhua Christian Hospital, Changhua, Taiwan 
 Research Education and Epidemiology Center, Changhua Christian Hospital, Changhua, Taiwan 
 Department of Orthopedic Surgery, Yuanlin Christian Hospital, Changhua, Taiwan 
 Orthopedic Research Centre, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Orthopedics, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan 
 Institute of Hospital Management, Tsinghua University, Beijing, China; Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Health Policy and Management, Bloomberg School of Public Health, John Hopkins University, Baltimore, Maryland, United States of America 
Pages
1-9
Publication year
2019
Publication date
Dec 2019
Publisher
Nature Publishing Group
e-ISSN
20452322
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2325911644
Copyright
© 2019. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.