The Clinical Frailty Scale offers little utility as part of a prediction model for community-dwelling older fallers at risk of re-presenting to the emergency department.
Loren Barton, Mark Nelson, Kirsten Strudwick, Corey Scholes
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引用次数: 0
Abstract
Background: There is no published literature on the predictive ability of the Clinical Frailty Scale (CFS) for falls risk specific to the Emergency Department (ED) population. This study aims to develop a prognostic model to determine the predictive ability of the CFS for ED falls' re-presentation in community-dwelling older people.
Methods: A retrospective observational cohort study was completed from July 2019 to July 2022 on community dwelling people aged 75 years and over who presented to the ED with an extrinsic fall and had a CFS score recorded. The primary outcome was fall-related re-presentation to ED; the secondary outcome was mortality. A flexible parametric survival model was applied with time to falls re-presentation, and post-estimation, used to predict the probability of another fall re-presentation within 6 months. Calibration was assessed and a decision support curve generated.
Results: The model demonstrated reasonable calibration-in-the-large (Slope = 0.999) and fit between CFS and probability of fall re-presentation. The CFS model displayed negligible discriminant ability (C-statistic = 0.534) for identifying older people at risk of falls-related ED re-presentations within 6 months of index presentation.
Conclusions: The CFS cannot be used to prognosticate an individual's risk of ED re-presentation within 6 months of an index extrinsic fall.
期刊介绍：
Australasian Emergency Care is an international peer-reviewed journal dedicated to supporting emergency nurses, physicians, paramedics and other professionals in advancing the science and practice of emergency care, wherever it is delivered. As the official journal of the College of Emergency Nursing Australasia (CENA), Australasian Emergency Care is a conduit for clinical, applied, and theoretical research and knowledge that advances the science and practice of emergency care in original, innovative and challenging ways. The journal serves as a leading voice for the emergency care community, reflecting its inter-professional diversity, and the importance of collaboration and shared decision-making to achieve quality patient outcomes. It is strongly focussed on advancing the patient experience and quality of care across the emergency care continuum, spanning the pre-hospital, hospital and post-hospital settings within Australasia and beyond.
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