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Effect of Frailty on Functional Gain, Resource Utilisation, and Discharge Destination: An Observational Prospective Study in a GEM Ward

Background. A geriatric evaluation and management unit (GEM) manages elderly inpatients with functional impairments. There is a paucity of literature on frailty and whether this impacts on rehabilitation outcomes. Objectives. To examine frailty score (FS) as a predictor of functional gain, resource...

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Autores principales: Kawryshanker, Sujatha, Raymond, Warren, Ingram, Katharine, Inderjeeth, Charles A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3948590/
https://www.ncbi.nlm.nih.gov/pubmed/24695584
http://dx.doi.org/10.1155/2014/357857
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author Kawryshanker, Sujatha
Raymond, Warren
Ingram, Katharine
Inderjeeth, Charles A.
author_facet Kawryshanker, Sujatha
Raymond, Warren
Ingram, Katharine
Inderjeeth, Charles A.
author_sort Kawryshanker, Sujatha
collection PubMed
description Background. A geriatric evaluation and management unit (GEM) manages elderly inpatients with functional impairments. There is a paucity of literature on frailty and whether this impacts on rehabilitation outcomes. Objectives. To examine frailty score (FS) as a predictor of functional gain, resource utilisation, and destinations for GEM patients. Methods. A single centre prospective case study design. Participants (n = 136) were ≥65 years old and admitted to a tertiary hospital GEM. Five patients were excluded by the preset exclusion criteria, that is, medically unstable, severe dementia or communication difficulties after stroke. Core data included demographics, frailty score (FS), and functional independence. Results. The mean functional improvement (FIM) from admission to discharge was 11.26 (95% CI 8.87, 13.66; P < 0.001). Discharge FIM was positively correlated with admission FIM (β = 0.748; P < 0.001) and negatively correlated with frailty score (β = −1.151; P = 0.014). The majority of the patients were in the “frail” group. “Frail” and “severely frail” subgroups improved more on mean FIM scores at discharge, relative to that experienced by the “pre-frail” group. Conclusion. All patients experienced functional improvement. Frailer patients improved more on their FIM and improved relatively more than their prefrail counterparts. Higher frailty correlated with reduced independence and greater resource utilisation. This study demonstrates that FS could be a prognostic indicator of physical independence and resource utilisation.
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spelling pubmed-39485902014-04-02 Effect of Frailty on Functional Gain, Resource Utilisation, and Discharge Destination: An Observational Prospective Study in a GEM Ward Kawryshanker, Sujatha Raymond, Warren Ingram, Katharine Inderjeeth, Charles A. Curr Gerontol Geriatr Res Research Article Background. A geriatric evaluation and management unit (GEM) manages elderly inpatients with functional impairments. There is a paucity of literature on frailty and whether this impacts on rehabilitation outcomes. Objectives. To examine frailty score (FS) as a predictor of functional gain, resource utilisation, and destinations for GEM patients. Methods. A single centre prospective case study design. Participants (n = 136) were ≥65 years old and admitted to a tertiary hospital GEM. Five patients were excluded by the preset exclusion criteria, that is, medically unstable, severe dementia or communication difficulties after stroke. Core data included demographics, frailty score (FS), and functional independence. Results. The mean functional improvement (FIM) from admission to discharge was 11.26 (95% CI 8.87, 13.66; P < 0.001). Discharge FIM was positively correlated with admission FIM (β = 0.748; P < 0.001) and negatively correlated with frailty score (β = −1.151; P = 0.014). The majority of the patients were in the “frail” group. “Frail” and “severely frail” subgroups improved more on mean FIM scores at discharge, relative to that experienced by the “pre-frail” group. Conclusion. All patients experienced functional improvement. Frailer patients improved more on their FIM and improved relatively more than their prefrail counterparts. Higher frailty correlated with reduced independence and greater resource utilisation. This study demonstrates that FS could be a prognostic indicator of physical independence and resource utilisation. Hindawi Publishing Corporation 2014 2014-02-17 /pmc/articles/PMC3948590/ /pubmed/24695584 http://dx.doi.org/10.1155/2014/357857 Text en Copyright © 2014 Sujatha Kawryshanker et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Kawryshanker, Sujatha
Raymond, Warren
Ingram, Katharine
Inderjeeth, Charles A.
Effect of Frailty on Functional Gain, Resource Utilisation, and Discharge Destination: An Observational Prospective Study in a GEM Ward
title Effect of Frailty on Functional Gain, Resource Utilisation, and Discharge Destination: An Observational Prospective Study in a GEM Ward
title_full Effect of Frailty on Functional Gain, Resource Utilisation, and Discharge Destination: An Observational Prospective Study in a GEM Ward
title_fullStr Effect of Frailty on Functional Gain, Resource Utilisation, and Discharge Destination: An Observational Prospective Study in a GEM Ward
title_full_unstemmed Effect of Frailty on Functional Gain, Resource Utilisation, and Discharge Destination: An Observational Prospective Study in a GEM Ward
title_short Effect of Frailty on Functional Gain, Resource Utilisation, and Discharge Destination: An Observational Prospective Study in a GEM Ward
title_sort effect of frailty on functional gain, resource utilisation, and discharge destination: an observational prospective study in a gem ward
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3948590/
https://www.ncbi.nlm.nih.gov/pubmed/24695584
http://dx.doi.org/10.1155/2014/357857
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