Cargando…
Frailty as a predictor of hospital length of stay after elective total joint replacements in elderly patients
BACKGROUND: Total joint replacement procedures are increasing in number because of population aging and osteoarthritis development. Defined as a lack of physiological reserves and the inability to adequately respond to external stressors, frailty may be more common than expected in older patients wi...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5771036/ https://www.ncbi.nlm.nih.gov/pubmed/29338705 http://dx.doi.org/10.1186/s12891-018-1935-8 |
_version_ | 1783293184287178752 |
---|---|
author | Wang, Han Ting Fafard, Josée Ahern, Stéphane Vendittoli, Pascal-André Hebert, Paul |
author_facet | Wang, Han Ting Fafard, Josée Ahern, Stéphane Vendittoli, Pascal-André Hebert, Paul |
author_sort | Wang, Han Ting |
collection | PubMed |
description | BACKGROUND: Total joint replacement procedures are increasing in number because of population aging and osteoarthritis development. Defined as a lack of physiological reserves and the inability to adequately respond to external stressors, frailty may be more common than expected in older patients with degenerative arthritis awaiting total joint replacements. The aim of the present study was to assess associations between frailty and adverse outcomes, frailty prevalence among elderly patients awaiting elective TJR, and agreement between 2 frailty screening instruments. METHODS: We undertook a prospective, observational, pilot study in our institution. We enrolled patients 65 years or older who were awaiting elective knee or hip replacement surgery and evaluated them in our preoperative clinic with planned postoperative hospital length of stay greater than 24 h. Patients were asked to grade their perceived well-being on the Clinical Frailty Scale and to answer questions on the FRAIL Scale. RESULTS: The Clinical Frailty Scale classified 40 patients (45.9%) as robust, 43 patients (49.4%) as prefrail and 4 patients (4.5%) as frail, while the FRAIL Scale categorized 12 patients (13.7%) as robust, 54 patients (62.0%) as prefrail, and 20 patients (22.9%) as frail. Robustness, ascertained on the Clinical Frailty Scale was, while the FRAIL Scale was not, significantly associated with shorter hospital length of stay and fewer discharges to the rehabilitation center. Both scales showed moderate mutual agreement. CONCLUSION: Screening for frailty identified between 5% and 10% of patients at risk of adverse outcomes. The Clinical Frailty Scale was, while the FRAIL scale was not, significantly associated with hospital length of stay and discharge to rehabilitation center in our cohort of total joint replacement patients. |
format | Online Article Text |
id | pubmed-5771036 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-57710362018-01-25 Frailty as a predictor of hospital length of stay after elective total joint replacements in elderly patients Wang, Han Ting Fafard, Josée Ahern, Stéphane Vendittoli, Pascal-André Hebert, Paul BMC Musculoskelet Disord Research Article BACKGROUND: Total joint replacement procedures are increasing in number because of population aging and osteoarthritis development. Defined as a lack of physiological reserves and the inability to adequately respond to external stressors, frailty may be more common than expected in older patients with degenerative arthritis awaiting total joint replacements. The aim of the present study was to assess associations between frailty and adverse outcomes, frailty prevalence among elderly patients awaiting elective TJR, and agreement between 2 frailty screening instruments. METHODS: We undertook a prospective, observational, pilot study in our institution. We enrolled patients 65 years or older who were awaiting elective knee or hip replacement surgery and evaluated them in our preoperative clinic with planned postoperative hospital length of stay greater than 24 h. Patients were asked to grade their perceived well-being on the Clinical Frailty Scale and to answer questions on the FRAIL Scale. RESULTS: The Clinical Frailty Scale classified 40 patients (45.9%) as robust, 43 patients (49.4%) as prefrail and 4 patients (4.5%) as frail, while the FRAIL Scale categorized 12 patients (13.7%) as robust, 54 patients (62.0%) as prefrail, and 20 patients (22.9%) as frail. Robustness, ascertained on the Clinical Frailty Scale was, while the FRAIL Scale was not, significantly associated with shorter hospital length of stay and fewer discharges to the rehabilitation center. Both scales showed moderate mutual agreement. CONCLUSION: Screening for frailty identified between 5% and 10% of patients at risk of adverse outcomes. The Clinical Frailty Scale was, while the FRAIL scale was not, significantly associated with hospital length of stay and discharge to rehabilitation center in our cohort of total joint replacement patients. BioMed Central 2018-01-16 /pmc/articles/PMC5771036/ /pubmed/29338705 http://dx.doi.org/10.1186/s12891-018-1935-8 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Wang, Han Ting Fafard, Josée Ahern, Stéphane Vendittoli, Pascal-André Hebert, Paul Frailty as a predictor of hospital length of stay after elective total joint replacements in elderly patients |
title | Frailty as a predictor of hospital length of stay after elective total joint replacements in elderly patients |
title_full | Frailty as a predictor of hospital length of stay after elective total joint replacements in elderly patients |
title_fullStr | Frailty as a predictor of hospital length of stay after elective total joint replacements in elderly patients |
title_full_unstemmed | Frailty as a predictor of hospital length of stay after elective total joint replacements in elderly patients |
title_short | Frailty as a predictor of hospital length of stay after elective total joint replacements in elderly patients |
title_sort | frailty as a predictor of hospital length of stay after elective total joint replacements in elderly patients |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5771036/ https://www.ncbi.nlm.nih.gov/pubmed/29338705 http://dx.doi.org/10.1186/s12891-018-1935-8 |
work_keys_str_mv | AT wanghanting frailtyasapredictorofhospitallengthofstayafterelectivetotaljointreplacementsinelderlypatients AT fafardjosee frailtyasapredictorofhospitallengthofstayafterelectivetotaljointreplacementsinelderlypatients AT ahernstephane frailtyasapredictorofhospitallengthofstayafterelectivetotaljointreplacementsinelderlypatients AT vendittolipascalandre frailtyasapredictorofhospitallengthofstayafterelectivetotaljointreplacementsinelderlypatients AT hebertpaul frailtyasapredictorofhospitallengthofstayafterelectivetotaljointreplacementsinelderlypatients |