• J. Am. Coll. Surg. · Jul 2014

    Observational Study

    Validating trauma-specific frailty index for geriatric trauma patients: a prospective analysis.

    • Bellal Joseph, Viraj Pandit, Bardiya Zangbar, Narong Kulvatunyou, Andrew Tang, Terence O'Keeffe, Donald J Green, Gary Vercruysse, Mindy J Fain, Randall S Friese, and Peter Rhee.
    • Department of Surgery, Division of Trauma, Critical Care, Burns, and Acute Care Surgery, University of Arizona Medical Center, Tuscon, AZ. Electronic address: bjoseph@surgery.arizona.edu.
    • J. Am. Coll. Surg. 2014 Jul 1; 219 (1): 10-17.e1.

    BackgroundThe Frailty Index has been shown to predict discharge disposition in geriatric patients. The aim of this study was to validate the modified 15-variable Trauma-Specific Frailty Index (TSFI) to predict discharge disposition in geriatric trauma patients. We hypothesized that TSFI can predict discharge disposition in geriatric trauma patients.Study DesignWe performed a 2-year (2011-2013) prospective analysis of all geriatric trauma patients presenting to our Level I trauma center. Patient discharge disposition was dichotomized into unfavorable (discharge to skilled nursing facility or death) and favorable (discharge to home or rehabilitation center) discharge disposition. Patients were evaluated using the developed 15-variable TSFI. Multivariate logistic regression was performed to identify factors that predict unfavorable discharge disposition.ResultsA total of 200 patients were enrolled for validation of TSFI. Mean age was 77 ± 12.1 years, median Injury Severity Score was 15 (interquartile range [IQR] 9 to 20), median Glasgow Coma Scale score was 14 (IQR 13 to 15), and median Frailty Index score was 0.20 (IQR 0.17 to 0.28); 29.5% (n = 59) patients had unfavorable discharge. After adjusting for age, sex, Injury Severity Score, Head Abbreviated Injury Scale, and vitals on admission, Frailty Index (odds ratio = 1.5; 95% CI, 1.1-2.5) was the only significant predictor for unfavorable discharge disposition. Age (odds ratio = 1.2; 95% CI, 0.9-3.1; p = 0.2) was not predictive of unfavorable discharge disposition.ConclusionsThe 15-variable TSFI is an independent predictor of unfavorable discharge disposition in geriatric trauma patients. The Trauma-Specific Frailty Index is an effective tool that can aid clinicians in planning discharge disposition of geriatric trauma patients.Level Of EvidenceII Prognostic Studies-Investigating the Effect of a Patient Characteristic on the Outcome of Disease.Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

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