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Prospective evaluation of health-related quality of life in geriatric trauma patients

Published on Sep 1, 2019in Surgery3.476
· DOI :10.1016/j.surg.2019.04.031
Chelsey Santino1
Estimated H-index: 1
(UA: University of Arizona),
Muhammad Zeeshan5
Estimated H-index: 5
(UA: University of Arizona)
+ 6 AuthorsBellal A Joseph27
Estimated H-index: 27
(UA: University of Arizona)
Sources
Abstract
Abstract Background Frailty is an established predictor of adverse outcomes in geriatric patients. Health-related quality of life (HRQoL) is an important outcome measure among trauma patients. This prospective observational study examined the impact of frailty on health-related quality of life in geriatric trauma patients. Methods We prospectively enrolled geriatric (age ≥65 years) trauma patients. We calculated the frailty index (FI) within 24 hours of admission using the trauma-specific frailty index. Patients were stratified into frail (frailty index ≥0.27) and nonfrail (frailty index Results We enrolled 296 patients. The mean age was 75.1 ± 9.8 years, 59% were male, and 81% were white. Frail patients accounted for 34%, and they had a lower health-related quality of life at discharge (366 vs 548, P 01) and at 30-day postdischarge (393 vs 744, P 01). Nonfrail patients scored higher in 6 out of 8 domains of health-related quality of life. Nonfrail patients had improved delta health-related quality of life ( P 01), unlike frail patients ( P = . 11). A linear regression model revealed an inverse relationship between frailty and improvement in health-related quality of life over 30-day postdischarge (β = –0.689, [confidence interval, –0.963 to –0.329] P = . 01). This association remained statistically significant after controlling for potential confounding covariates, such as age, sex, race, and injury severity. Conclusion Compared with nonfrail geriatric trauma patients, those who were frail had poor health-related quality of life at discharge and at 30-day postdischarge. Frailty negatively affects the recovery of health-related quality of life after trauma. The use of frailty indices may help identify and develop targeted interventions to improve health-related quality of life among geriatric trauma patients.
  • References (20)
  • Citations (1)
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References20
Newest
#1Mohammad Hamidi (UA: University of Arizona)H-Index: 4
#2Muhammad Zeeshan (UA: University of Arizona)H-Index: 5
Last. Bellal A Joseph (UA: University of Arizona)H-Index: 27
view all 10 authors...
Abstract Background The aim of our study was to assess the association between frailty and functional status in geriatric trauma patients. Methods 3-year(2013–2015) prospective analysis and included all geriatric trauma patients(≥65y) discharged to a single rehabilitation center from our level-I trauma center. Frailty was measured using Trauma-Specific-Frailty-Index(TSFI) while Functional status was assessed using functional-independence-measure(FIM) at admission and discharge from rehabilitatio...
2 CitationsSource
#1Muhammad Khan (UA: University of Arizona)H-Index: 6
#2Bellal A Joseph (UA: University of Arizona)H-Index: 27
Purpose of Review In contrast to their younger counterparts, geriatric patients have a decreased physiological reserve. This age-related vulnerability poses unique challenges for clinical decision-making. Additionally, as the population of the United States (U.S.) continues to age at a rapid pace, an increasing number of elderly patients need trauma care. Accordingly, this review examines the relevance of the concept of frailty in trauma cases, as well as its role in identifying vulnerable traum...
4 CitationsSource
#1Bellal A Joseph (UA: University of Arizona)H-Index: 27
#2Ahmed Hassan (UA: University of Arizona)H-Index: 11
Geriatric population is the fastest growing segment of the total population. They represent about 12 % of the US population. By the year 2030 it has been estimated that 19 % of the population will be older than 65 years. Currently elderly are more active and independent that increases the risk of trauma. Elderly are unique in their responses to trauma injury. The age-related physiological changes affect elderly ability to withstand trauma stress and increase the incidence of complications and de...
20 CitationsSource
#1Tahereh Orouji Jokar (UA: University of Arizona)H-Index: 8
#2Peter M Rhee (UA: University of Arizona)H-Index: 61
Last. Bellal A Joseph (UA: University of Arizona)H-Index: 27
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11 CitationsSource
#1Bellal A Joseph (UA: University of Arizona)H-Index: 27
#2Viraj Pandit (UA: University of Arizona)H-Index: 21
Last. Peter M Rhee (UA: University of Arizona)H-Index: 61
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Importance The Frailty Index (FI) is a known predictor of adverse outcomes in geriatric patients. The usefulness of the FI as an outcome measure in geriatric trauma patients is unknown. Objective To assess the usefulness of the FI as an effective assessment tool in predicting adverse outcomes in geriatric trauma patients. Design, Setting, and Participants A 2-year (June 2011 to February 2013) prospective cohort study at a level I trauma center at the University of Arizona. We prospectively measu...
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#1Bellal A Joseph (UA: University of Arizona)H-Index: 27
#2Viraj Pandit (UA: University of Arizona)H-Index: 21
Last. Peter M Rhee (UA: University of Arizona)H-Index: 61
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Background The 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 Design We performed a 2-year (2011–2013) prospective analysis of all geriatric trauma patients presenting to our Level I trauma center. Patie...
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Last. Murat YüminH-Index: 4
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Abstract The present study examined the effect of functional mobility and balance on HRQoL among elderly people living at home and those living in nursing homes. The study included 122 elderly people aged 65 and over. With regard to the individuals whose socio-demographic data were collected in the scope of the study, balance and functional mobility levels were evaluated using the timed up and go test (TUG) and Berg balance scale (BBS); HRQoL was evaluated using the Nottingham health profile (NH...
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#1Claudio Bilotta (University of Milan)H-Index: 11
#2Ann Bowling (UCL: University College London)H-Index: 59
Last. Carlo Vergani (Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico)H-Index: 35
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Background There is a lack of knowledge concerning the relationship between two closely-linked multidimensional variables: frailty and quality of life (QOL). The aim of this study was to investigate dimensions and correlates of QOL associated with frailty status among community-dwelling older outpatients.
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#1Lena ZidénH-Index: 10
#2M Kreuter (University of Gothenburg)H-Index: 23
Last. Kerstin Frändin (KI: Karolinska Institutet)H-Index: 21
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Purpose. To investigate the long-term effects of home rehabilitation (HR) after hip fracture in elderly people.Method. A randomized, controlled longitudinal study on geriatric hospital-based HR was compared with conventional care (CC) in 102 patients. Independence in activities of daily living (ADL), frequency of activity, basic physical performance, balance confidence, health-related quality of life, mood and perceived recovery were measured 6 and 12 months after discharge.Results. One year pos...
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The question of whether metabolic drug clearance is decreased in elderly people has been the subject of considerable debate and is very important because clearance is a determinant of dosing. Drug clearance has been shown to be consistently impaired for flow-limited (high-clearance) drugs, but there have been conflicting results for capacity-limited (low-clearance) drugs. A limitation of the studies of capacity-limited drugs is that most have estimated clearance based on total drug concentration...
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#1Robbert J. J. Gobbens (University of Antwerp)H-Index: 20
#2Jane Andreasen (AAU: Aalborg University)H-Index: 7
Abstract Purpose To assess the predictive value of three different frailty domains (physical, psychological, social) for both readmission and mortality in a population of acutely admitted older patients, and to determine which components of the individual three frailty domains had an effect on readmission and mortality. Methods This prospective cohort study was conducted in a sample of 1,328 Danish acutely admitted patients aged 65 years or older. The follow-up period on readmission and death wa...
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#1Mya Cubitt (Royal Melbourne Hospital)
#2Emma Downie (Royal Melbourne Hospital)
Last. Elaine Cole (QMUL: Queen Mary University of London)H-Index: 10
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Abstract Introduction The trauma population is aging and better prognostic measures for geriatric trauma patients are required. Frailty rather than age appears to be associated with poor outcomes. This systematic review aimed to identify the optimum frailty assessment instrument and timing of assessment in patients aged over 65 years admitted to hospital after traumatic injury. The secondary aim was to evaluate outcomes associated with frailty in elderly trauma populations. Methods This systemat...
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