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Frailty and length of stay in older adults with blunt injury in a national multicentre prospective cohort study

BACKGROUND: Patients suffering moderate or severe injury after low falls have higher readmission and long-term mortality rates compared to patients injured by high-velocity mechanisms such as motor vehicle accidents. We hypothesize that this is due to higher pre-injury frailty in low-fall patients,...

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Autores principales: Tan, Timothy Xin Zhong, Nadkarni, Nivedita V., Chua, Wei Chong, Loo, Lynette Ma, Iau, Philip Tsau Choong, Ang, Arron Seng Hock, Goo, Jerry Tiong Thye, Chan, Kim Chai, Malhotra, Rahul, Ong, Marcus Eng Hock, Matchar, David Bruce, Seow, Dennis Chuen Chai, Nguyen, Hai V., Ng, Yee Sien, Chan, Angelique, Wong, Ting-Hway
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8087011/
https://www.ncbi.nlm.nih.gov/pubmed/33930058
http://dx.doi.org/10.1371/journal.pone.0250803
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author Tan, Timothy Xin Zhong
Nadkarni, Nivedita V.
Chua, Wei Chong
Loo, Lynette Ma
Iau, Philip Tsau Choong
Ang, Arron Seng Hock
Goo, Jerry Tiong Thye
Chan, Kim Chai
Malhotra, Rahul
Ong, Marcus Eng Hock
Matchar, David Bruce
Seow, Dennis Chuen Chai
Nguyen, Hai V.
Ng, Yee Sien
Chan, Angelique
Wong, Ting-Hway
author_facet Tan, Timothy Xin Zhong
Nadkarni, Nivedita V.
Chua, Wei Chong
Loo, Lynette Ma
Iau, Philip Tsau Choong
Ang, Arron Seng Hock
Goo, Jerry Tiong Thye
Chan, Kim Chai
Malhotra, Rahul
Ong, Marcus Eng Hock
Matchar, David Bruce
Seow, Dennis Chuen Chai
Nguyen, Hai V.
Ng, Yee Sien
Chan, Angelique
Wong, Ting-Hway
author_sort Tan, Timothy Xin Zhong
collection PubMed
description BACKGROUND: Patients suffering moderate or severe injury after low falls have higher readmission and long-term mortality rates compared to patients injured by high-velocity mechanisms such as motor vehicle accidents. We hypothesize that this is due to higher pre-injury frailty in low-fall patients, and present baseline patient and frailty demographics of a prospective cohort of moderate and severely injured older patients. Our second hypothesis was that frailty was associated with longer length of stay (LOS) at index admission. METHODS: This is a prospective, nation-wide, multi-center cohort study of Singaporean residents aged ≥55 years admitted for ≥48 hours after blunt injury with an injury severity score or new injury severity score ≥10, or an Organ Injury Scale ≥3, in public hospitals from 2016–2018. Demographics, mechanism of injury and frailty were recorded and analysed by Chi-square, or Kruskal-Wallis as appropriate. RESULTS: 218 participants met criteria and survived the index admission. Low fall patients had the highest proportion of frailty (44, 27.3%), followed by higher level fallers (3, 21.4%) and motor vehicle accidents (1, 2.3%) (p < .01). Injury severity, extreme age, and surgery were independently associated with longer LOS. Frail patients were paradoxically noted to have shorter LOS (p < .05). CONCLUSION: Patients sustaining moderate or severe injury after low falls are more likely to be frail compared to patients injured after higher-velocity mechanisms. However, this did not translate into longer adjusted LOS in hospital at index admission.
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spelling pubmed-80870112021-05-06 Frailty and length of stay in older adults with blunt injury in a national multicentre prospective cohort study Tan, Timothy Xin Zhong Nadkarni, Nivedita V. Chua, Wei Chong Loo, Lynette Ma Iau, Philip Tsau Choong Ang, Arron Seng Hock Goo, Jerry Tiong Thye Chan, Kim Chai Malhotra, Rahul Ong, Marcus Eng Hock Matchar, David Bruce Seow, Dennis Chuen Chai Nguyen, Hai V. Ng, Yee Sien Chan, Angelique Wong, Ting-Hway PLoS One Research Article BACKGROUND: Patients suffering moderate or severe injury after low falls have higher readmission and long-term mortality rates compared to patients injured by high-velocity mechanisms such as motor vehicle accidents. We hypothesize that this is due to higher pre-injury frailty in low-fall patients, and present baseline patient and frailty demographics of a prospective cohort of moderate and severely injured older patients. Our second hypothesis was that frailty was associated with longer length of stay (LOS) at index admission. METHODS: This is a prospective, nation-wide, multi-center cohort study of Singaporean residents aged ≥55 years admitted for ≥48 hours after blunt injury with an injury severity score or new injury severity score ≥10, or an Organ Injury Scale ≥3, in public hospitals from 2016–2018. Demographics, mechanism of injury and frailty were recorded and analysed by Chi-square, or Kruskal-Wallis as appropriate. RESULTS: 218 participants met criteria and survived the index admission. Low fall patients had the highest proportion of frailty (44, 27.3%), followed by higher level fallers (3, 21.4%) and motor vehicle accidents (1, 2.3%) (p < .01). Injury severity, extreme age, and surgery were independently associated with longer LOS. Frail patients were paradoxically noted to have shorter LOS (p < .05). CONCLUSION: Patients sustaining moderate or severe injury after low falls are more likely to be frail compared to patients injured after higher-velocity mechanisms. However, this did not translate into longer adjusted LOS in hospital at index admission. Public Library of Science 2021-04-30 /pmc/articles/PMC8087011/ /pubmed/33930058 http://dx.doi.org/10.1371/journal.pone.0250803 Text en © 2021 Tan et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Tan, Timothy Xin Zhong
Nadkarni, Nivedita V.
Chua, Wei Chong
Loo, Lynette Ma
Iau, Philip Tsau Choong
Ang, Arron Seng Hock
Goo, Jerry Tiong Thye
Chan, Kim Chai
Malhotra, Rahul
Ong, Marcus Eng Hock
Matchar, David Bruce
Seow, Dennis Chuen Chai
Nguyen, Hai V.
Ng, Yee Sien
Chan, Angelique
Wong, Ting-Hway
Frailty and length of stay in older adults with blunt injury in a national multicentre prospective cohort study
title Frailty and length of stay in older adults with blunt injury in a national multicentre prospective cohort study
title_full Frailty and length of stay in older adults with blunt injury in a national multicentre prospective cohort study
title_fullStr Frailty and length of stay in older adults with blunt injury in a national multicentre prospective cohort study
title_full_unstemmed Frailty and length of stay in older adults with blunt injury in a national multicentre prospective cohort study
title_short Frailty and length of stay in older adults with blunt injury in a national multicentre prospective cohort study
title_sort frailty and length of stay in older adults with blunt injury in a national multicentre prospective cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8087011/
https://www.ncbi.nlm.nih.gov/pubmed/33930058
http://dx.doi.org/10.1371/journal.pone.0250803
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