Older frail patients often don’t do well after hospital discharge

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Older frail patients often don't do well after hospital discharge
Older frail patients often don't do well after hospital discharge

It appears that being frail is certainly not in the best interests of elderly patients. The Canadian Medical Association reported, that frailer elderly patients are at an increased risk for readmission or even death within 30 days after they are discharged from the hospital. Health care professionals can make assessments of who is at risk by using the Clinical Frailty Scale.

It is very costly for the health care system to have patients readmitted within a short time after they are discharged from the hospital. By identifying patients who are at risk and addressing the factors which contribute to readmission it becomes possible to lower recurrences. The researchers determined whether or not the Clinical Frailty Scale can help to make accurate predictions of readmission or death within 30 days after hospital discharge in a group of 495 patients located at two Alberta hospitals.

The Clinical Frailty Scale was used to determine frailty. This scale measures difficulty in daily living activities with mild frailty, or a score of 5, being associated with difficulty with one or more complicated daily living activities such as shopping, finances, meal preparation and housework. Moderate frailty, or a score of 6, indicates there is difficulty in dressing, bathing or climbing stairs. Severe frailty, or a score of 7, means that a patient is physically or mentally dependent on someone to help with three or more daily living activities.

In the study in comparison with nonfrail patients the frail patients were found to be at greater risk of readmission or death within 30 days, at 24 percent versus 14 percent. Patients with moderate or severe frailty had a 31 percent risk of readmission or death within 30 days. The inclusion of frailty assessments improved the prediction outcomes after discharge. The researchers have therefore suggested that this assessment should be included in discharge planning procedures to help identify patients who are at highest risk of making a poor transition from the hospital to home.

This study has been published in the Canadian Medical Association Journal. It was determined by researchers that frailty was common and was associated with a considerably increased risk of early readmission or death after being discharged from medical wards. This finding should be helpful in identifying patients who are at high risk who are discharged from general internal medicine wards. Better planning for the discharge of patients with this information in mind could save lives.

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