123 * FRAILTY PREDICTORS AND OUTCOMES FOR GERIATRIC IN-PATIENTS

Abstract

Introduction: Frailty results in vulnerability which increases adverse outcomes, such as disability, falls, institutionalisation, hospitalisation, and mortality. Our average length of stay (LOS) is above national average therefore we wanted to test the hypotheses that frailty is a contributor, and among many frailty indicators recorded routinely during admission; if there are any significant predictors.Method: This is a retrospective cohort study of case notes of the patients who were admitted to the geriatric ward at the Royal Bournemouth Hospital.Length of stay as dependent variable was studied for frailty indicators as independent variables; demographics, socio-economic status, mini-mental state examination (MMSE), geriatric depression score (GDS), MUST score, Barthel index, medications, previous falls, elderly mobility score (EMS), Waterloo scores, BMI, co-morbidities: AF, CCF, CKD, IHD were recorded and subsequently analysed (SAS9.2).Results: 53 patients were recruited, 49% were males and mean age was 86 years. 40/53(75.5%) stayed on the ward for more than a week. 18/40 vs 4/13 had a Barthel score <25, p = 0.022,OR 0.51(95%CI 0.03 to 0.98). 18/40 vs 2/13 had a very high Waterloo pressure sore score (20+), p = 0.007, OR 1.141(95%CI 0.02 to 0.81).26/40(65%) in the long stay vs 11/13(84%) had history of falls. However this was not significant. There was no significant difference for cardiovascular disease, BMI, MMSE and EMS in the length of stay.37/53 had previous history of falls. Only 6 ( 16.2%) of those with previous falls were on bone protection medication. 10/37 of fallers had an EMS score <5 (p = 0.055). The remaining parameters comparing against fall were insignificant.Conclusion: It is observed that the frailty score, such as Barthel and Waterloo are significant predictors of LOS, however no significant correlation was found for MMSE, MUST score, IHD, mortality, falls and cardiovascular health. As this is a pilot study, the results documented are preliminary data.