The FRAIL Questionnaire: A Useful Tool for Bedside Screening of Geriatric Trauma Patients

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Abstract

Frailty screening is a priority in acute care. Using secondary data from our prior study, we derived a 5-item FRAIL Questionnaire (instrument) score for 188 geriatric trauma patients and aimed to examine the influence of preinjury physical frailty (as measured by FRAIL) on 1-year outcomes. The study used a secondary data analysis design. Patients were 65 years and older admitted through the emergency department (ED) between October 2013 and March 2014. The 5 items of the FRAIL instrument were identified within data sources of our prior study, and a preinjury FRAIL score was created for each patient. For data analysis, frequencies, measures of central tendency, and linear and logistic regression models were used. Median age of the patients was 77 years (interquartile range [IQR] = 69–86), and median Injury Severity Score = 10 (IQR = 9–17). Upon admission to the ED, 63 patients (34%) were screened as frail (FRAIL score ≥3), 71 (38%) as prefrail (score = 1–2), and 54 (29%) as nonfrail (score = 0). Frequencies for components of the FRAIL score were as follows: fatigue (N = 123; 65%), resistance (N = 61; 32%), ambulation (N = 76; 40%), illnesses (N = 51; 27%), and loss of weight (N = 11; 6%). After controlling for age, comorbidities, injury severity, and cognitive status, preinjury FRAIL scores explained 13% of the variability in function as measured by the Barthel Index (N = 129, β = .36, p < .001). Forty-seven patients died (26%) within 1 year. Logistic regression analysis revealed that the higher the preinjury FRAIL score, the greater the likelihood of mortality within 1 year (OR = 1.74, p = .001; 95% CI [1.27, 2.39)]. The FRAIL Questionnaire predicts 1-year functional status and mortality and is a useful tool for bedside screening.

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