Scoring the Clinical Frailty Scale in the Emergency Department: The Home FIRsT Experience.
Thorpe, Owen; McCabe, Elva; Herrero, Elena Marie; Doyle, William Ormiston; Dillon, Aoife; Edge, Lucinda; Flynn, Sinéad; Mullen, Anna; Davis, Aisling; Molamphy, Aoife; Kirwan, Anna; Briggs, Robert; Lavan, Amanda H; Shields, Darragh; McMahon, Geraldine; Hennessy, Arthur; Kennedy, Una; Staunton, Paul; Kidney, Emer; Yeung, Sarah-Jane; Glynn, Deirdre; Horgan, Frances; Cunningham, Conal; Romero-Ortuno, Roman
We evaluated predictors of the Clinical Frailty Scale (CFS) scored by an interdisciplinary team (Home FIRsT) performing comprehensive geriatric assessment (CGA) in our Emergency Department (ED). This was a retrospective observational study (service evaluation) utilising ED-based CGA data routinely collected by Home FIRsT between January and October 2020. A linear regression model was computed to establish independent predictors of CFS. This was complemented by a classification and regression tree (CRT) to evaluate the main predictors. There were 799 Home FIRsT episodes, of which 740 were unique patients. The CFS was scored on 658 (89%) (median 4, range 1-8; mean age 81 years, 61% women). Independent predictors of higher CFS were older age (p<0.001), history of dementia (p<0.001), mobility (p≤0.007), disability (p<0.001), and higher acuity of illness (p=0.009). Disability and mobility were the main classifiers in the CRT. Results suggest appropriate CFS scoring informed by functional baseline.
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