Abstract
Background
Frail older adults are frequently admitted to hospital with complex care needs, however
little is known about their clinical profile, inpatient management or outcomes.
Aims
(i) To establish a baseline clinical profile of patients with frailty; (ii) To obtain
a representative cross-sectional view of patients with frailty and their acute inpatient
clinical management; (iii) To determine the rate and clinical outcomes of frailty
among hospitalised patients.
Methods
The study will be conducted in a Western Sydney tertiary teaching hospital (Blacktown
and Mount Druitt Hospital), serving a large socio-economically diverse, multi-cultural
community. A long-term, prospective observational clinical cohort of patients who
are admitted under Rehabilitation and Aged Care Services over the next 5-year period
(2020–25) will be conducted. Frailty will be assessed using the Clinical Frailty Scale,
and the FI-ED frailty instrument, performance will be assessed using the Australian-modified
Karnofsky Performance Status (AKPS). Participants will be followed-up at 3, 6, and
12 months by telephone, following their index hospitalisation. Outcomes of interest
include all-cause rehospitalisation (including emergency department presentation),
mortality and admission to residential aged care service over the period of 12 months.
Data Linkage endpoint assessment will be undertaken at 1, 2, and 5 years.
Discussion
Frailty is an emergent area of clinical and research interest. It is an important
prognostic indicator of mortality, rehospitalisation and institutionalisation.
Conclusion
This study will provide longitudinal data to demonstrate short, mid, or long-term
outcomes of hospitalised frail older adults. Data will be used to inform future studies
and quality improvement activities.
Impact
It is envisioned that the registry will act as a spine project for future multi-disciplinary
research opportunities including interventional studies, data linkage studies and
quality improvement projects, thus enabling robust medium – long term examination
of outcomes of interest, such as mortality, rehospitalisation and admission to residential
aged care within this area of growing concern. There are plans to engage more disciplines
in the registry's research capacity-building endeavours and we have identified the
need for greater consumer engagement and public involvement. The sustainability of
the registry needs to be considered within the context of ongoing research funding
and making better use of these data for continuous quality improvement.
Registry registration
The registry was registered with the Australian Register of Clinical Registries (Australian
Commission on Safety and Quality in Healthcare) on 3rd August 2020.(
Australian Commission on Safety and Quality in Healthcare 2020
) Reference ACSQHC-ARCR-095. Available via https://www.safetyandquality.gov.au/australian-register-clinical-registriesAustralian Commission on Safety and Quality in Healthcare. (2020). Australian Register of Clinical Registries. Retrieved 08/09/2020 from https://www.safetyandquality.gov.au/australian-register-clinical-registries.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to CollegianAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- The Australia-modified Karnofsky Performance Status (AKPS) scale: A revised scale for contemporary palliative care clinical practice [ISRCTN81117481].BMC Palliative Care. 2005; 4: 7https://doi.org/10.1186/1472-684X-4-7
Australian Commission on Safety and Quality in Healthcare. (2020). Australian Register of Clinical Registries. Retrieved 08/09/2020 from https://www.safetyandquality.gov.au/australian-register-clinical-registries.
- Identification of older adults with frailty in the Emergency Department using a frailty index: Results from a multinational study.Age and Ageing. 2018; 47: 242-248https://doi.org/10.1093/ageing/afx168
- Validation of a combined comorbidity index.Journal of Clinical Epidemiology. 1994; 47: 1245-1251https://doi.org/10.1016/0895-4356(94)90129-5
- Prevalence of frailty in community-dwelling older persons: A systematic review.Journal of American Geriatric Society. 2012; 60: 1487-1492https://doi.org/10.1111/j.1532-5415.2012.04054.x
Costa, A. P., Hirdes, J. P., & Arino-Blasco, S. Berg K., Boscart V. M., Carpenter C. R., et al. (2017). Inter RAI Emergency Department (ED) Assessment System Manual: For use with the interRAI ED Screener (EDS) and ED Contact Assessment (ED-CA), (Standard English Edition), 9.3.0.
- Management of frailty: Opportunities, challenges, and future directions.The Lancet. 2019; 394: 1376-1386https://doi.org/10.1016/S0140-6736(19)31785-4
- Research electronic data capture (REDCap)–a metadata-driven methodology and workflow process for providing translational research informatics support.Journal of Biomedical Informatics. 2009; 42: 377-381https://doi.org/10.1016/j.jbi.2008.08.010
- Dementia treatment: the need for a paradigm shift.Australasian Journal on Ageing. 2019; 38: 149-150https://doi.org/10.1111/ajag.12698
NHMRC, 2018. National Statement on Ethical Conduct in Human Research 2007 (Updated 2018). The National Health and Medical Research Council, the Australian Research Council and Universities Australia. Commonwealth of Australia, Canberra. Available via https://www.nhmrc.gov.au/about-us/publications/national-statement-ethical-conduct-human-research-2007-updated-2018, Accessed 24th Sept 2022.
- A global clinical measure of fitness and frailty in elderly people.Canadian Medical Association Journal. 2005; 173: 489https://doi.org/10.1503/cmaj.050051
Article info
Publication history
Published online: October 03, 2022
Accepted:
September 13,
2022
Received in revised form:
August 17,
2022
Received:
March 23,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Australian College of Nursing Ltd. Published by Elsevier Ltd.
