@article{ref1,
title="Managing older adults with ground-level falls admitted to a trauma service: the effect of frailty",
journal="Journal of the American Geriatrics Society",
year="2015",
author="Joseph, Bellal and Pandit, Viraj and Khalil, Mazhar and Kulvatunyou, Narong and Zangbar, Bardiya and Friese, Randall S. and Mohler, M. Jane and Fain, Mindy J. and Rhee, Peter",
volume="63",
number="4",
pages="745-749",
abstract="OBJECTIVES: To determine whether frail elderly adults are at greater risk of fracture after a ground-level fall (GLF) than those who are not frail. <br><br>DESIGN: Prospective observational study. SETTING: Level 1 trauma center. PARTICIPANTS: All elderly (≥65) adults presenting after a GLF over 1 year (N = 110; mean age ± SD 79.5 ± 8.3, 54% male). MEASUREMENT: A Frailty Index (FI) was calculated using 50 preadmission frailty variables. Participants with a FI of 0.25 or greater were considered to be frail. The primary outcome measure was a new fracture; 40.1% (n = 45) of participants presented with a new fracture. The secondary outcome was discharge to an institutional facility (rehabilitation center or skilled nursing facility). Multivariate logistic regression was performed. <br><br>RESULTS: Forty-three (38.2%) participants were frail. The median Injury Severity Score was 14 (range 9-17), and the mean FI was 0.20 ± 0.12. Frail participants were more likely than those who were not frail to have fractures (odds ratio (OR) = 1.8, 95% confidence interval (CI) = 1.2-2.3, P = .01). Thirty-six (32.7%) participants were discharged to an institutional facility. Frail participants were more likely to be discharged to an institutional facility (OR = 1.42, 95% CI = 1.08-3.09, P = .03) after a GLF. <br><br>CONCLUSION: Frail individuals have a higher likelihood of fractures and discharge to an institutional facility after a GLF than those who are not frail. The FI may be used as an adjunct for decision-making when developing a discharge plan for an elderly adult after a GLF.<p /> <p>Language: en</p>",
language="en",
issn="0002-8614",
doi="10.1111/jgs.13338",
url="http://dx.doi.org/10.1111/jgs.13338"
}