Loss of Independence (LOI) - a Rapid Alternative to Frailty Screening in a Swedish Emergency Department Setting
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 1,800
- 试验地点
- 3
- 主要终点
- Mortality in 30 Days
研究概览
简要总结
This prospective observational study will investigate the correlation of a surrogate marker of frailty in relation to serious outcomes. Serious outcomes are defined as: mortality within 30 days, admission to hospital, length of stay in the Emergency Department (ED), in-hospital Length of Stay and revisits to the ED.
The exposure, frailty, will be assessed according to Loss of Independence (LOI) a possible low-cost quick tool to identify frailty in patients. The study population will be ED patients, >65 years of age in a Swedish regional health care system (Region Östergötland, Sweden), comprising three EDs in Linköping, Norrköping and Motala. The outcomes will be compared according to the degree of frailty and censored over 7, 30 and 90 days.
详细描述
Frailty is a common clinical syndrome in older adults that carries an increased risk for poor health outcomes including falls, incident disability, hospitalization and mortality.
The Loss of Independence (LOI) defined as inability to rise from a chair with or without existing aids, is a possible low cost surrogate marker to measure frailty. Several studies on triage scores for predicting mortality and need of hospital admission have identified LOI as one of the most important variables. LOI was prognostic in ED populations regarding mortality within 1-30 days in Denmark, Ireland and Tanzania. Data from the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) Geriatric Surgery Pilot Project showed that LOI was associated with higher rates of readmission and death after discharge in geriatric patients undergoing surgical procedures6.
The aim of this study will be to investigate if the frailty, as assessed with LOI, is associated with increased 30-day mortality in a Swedish ED context. Secondary outcomes include 7- and 90-day mortality, ED-length of stay, hospital admission, in-hospital length of stay, subsequent falls and medication changes. Additionally, we collect data on morbidity and comorbidities to assess the association with the level of frailty. Since this is a multicentre study, possible geographic differences will be studied as well. Based on the results of this study, possible interventions could be identified to improve the care of the frail geriatric patients presenting at the ED.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 65 Years 至 —（Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •≥ 65 years
- •able to answer questions to estimate frailty
- •or have a proxy to answer questions
排除标准
- •<65 years
- •unable to answer questions to estimate frailty
结局指标
主要结局
Mortality in 30 Days
时间窗: All cause mortality up to 30 days from index visit
Investigate level of mortality in cohort at 30 days
次要结局
- Mortality in 7 and 90 days(All cause mortality up to 90 days from index visit)
- Revisits to the ED(Number of newly registered visits to the ED after index visit, censored at 90 days)
- ED length of stay(Length of stay at ED, censored at 4 days)
- In-hospital length of stay(In-hospital length of stay from index visit, censored at 90 days)
- Alterations in medication during the visit(Alterations in medication during the ED visit and during the follow-up period, censored at 90 days)
- Admission to hospital(Hospital admission on index visit, censored at 90 days)
- Fall prevalence after index visit(Falls that resulted in further health care contacts after index visit, censored at 90 days)
研究者
Daniel Wilhelms
Principal Investigator
University Hospital, Linkoeping