Background: Managing acute admission of frail older patients is a big challenge in hospitals. Length of in-patient stay, in-patient mortality and 90-days readmission are significant in this group of patients. The Comprehensive Geriatric Assessment (CGA) is the best approach in acute geriatric care.
Methods: A survey on the records of older patients aged 75 and above, acutely admitted to a district general hospital, England from the 15th March 2012 to 16th April 2012 was conducted. A simple frailty assessment tool was developed and based on existing literature. Inter-observer reproducibility was good. Using this assessment tool frailty screening was undertaken and provision of CGA was evaluated in the group of patients who fulfilled criteria of frailty. All data of patients were processed and analyzed using STATA 11 software (Statistical package for data analysis).
Results: A total of 232 patients with mean age of 84.25 ± 5.8 years were involved. 129 out of a total of 232 patients (55.6%) fulfilled frailty criteria of the survey. Among 129 frail patients 80.6% presented with lack of mobility over 24 hours, 69.8% admitted with falls, 47.3% had known dementia or delirium and 45% admitted from care homes. Patients aged above 85 years were more likely to have frailty compared to patients aged 75- 85 years old (OR: 4.78, 95% CI: 2.6-8.6, P- value <0.001). Patients assessed by a front door geriatric team were more likely to receive CGA than those not seen by the front door geriatric team (adjusted OR 2.8, 95% CI: 1-7.6, P- value 0.04).
Conclusion: Prevalence of frailty is high in acute admissions of older patients. Therefore it is imperative to conduct frailty screening and deliver CGA to these frail older patients in hospitals.