54ASSESSMENT OF FRAILTY SYNDROME IN GENERAL PRACTICE BY THE USE OF THE MODIFIED SEGA GRID IN GENERAL PRACTICE

Abstract

Introduction: It seems necessary to be able to prevent a frail state onset in elderly patients. Methods: We carried out a cross-section observational study in subjects aged 75 years or older, during a general non-dedicated consultation in several practices in the Marne (France) between 02 May 2016 and 08 May 2017. Screening for frailty was carried out using the modified SEGA (SEGAm) grid. Results: 64 patients were included. The average age of the population was 80 years +/- 3.87, with a female majority. The sample was divided into two distinct groups according to their frailty level. A total of 50 patients were non-frail and 14 patients were frail. The average frailty SEGAm tool score for the total population study was 6.3 +/- 3.6. The mean frailty score of the “non-frail” population was 4.76 (<8, ie not very frail) and 11.79 for the frail population (≥8, frail and very frail), with a significance threshold equal to 1% (p = 1.13E-08). The time taken to run the SEGAm grid distinguished the 2 groups with a significance threshold of 1% (p = 2.33E-03). On average, the time needed to achieve the SEGAm score was 3 minutes and 55 seconds (+/- 1.13). Frail patients averaged 4 minutes and 43 seconds to perform the test, while 3 minutes and 30 seconds for nonfrail patients. We found a significant difference in the ratio of subjects at risk of falling between the frail and non-frail groups with a significance threshold of 5% (p = 0.01). We also found a significant difference for 93% of subjects in the “frail” group with a 1% significance threshold (p = 2.9e-05). We found no significant difference in malnutrition, sex, marital status and cognitive impairment. Several variables were indicators distinguishing between the two groups, including the age of patients with a higher age in the frail group (p = 0.04), Charlson score with a higher score in the frail group (p = 0.016) the Mini mental state with a higher mean in the non-frail group (p = 0.011). The Kappa score was 0.66, corresponding to a good agreement between the SEGA grid and the doctor's opinion Conclusion: It is widely available to other medical and paramedical health professionals, thus it helps target a wider population.