Concordance with routine Clinical Frailty Scale screening in the frailty in European emergency departments (FEED) study

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing Pub Date : 2025-02-01 DOI:10.1016/j.ienj.2024.101565

Georgia Eagleton , Ramazan Güven , Thordis Thorsteinsdóttir , Evgeny Mirkes , James D. van Oppen , On behalf of the European Taskforce on Geriatric Emergency Medicine collaborators

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引用次数: 0

Abstract

Background

Frailty screening determines who receive geriatric emergency medicine interventions that are of high importance for patient outcomes. However, post-implementation evaluations show around 50% older Emergency Department (ED) attenders to receive screening. Why and who are omitted from screening remains largely unstudied. This study gave opportunity to compare normal screening status to data from a targeted screening study.

Methods

The parent Frailty in European Emergency Departments (FEED) study administered the Clinical Frailty Scale (CFS) to consecutive ED attenders on 04 July 2023. This present study considered a subset of sites which provided retrievable CFS data from a “normal day” two weeks prior. Symmetry and dependency of missing CFS entries with observed variables were assessed. The frailty distribution was then compared with the parent FEED study data.

Results

A minority of sites (5/62) recorded CFS in retrievable format. 55 % “normal day” CFS entries were missing compared with 14 % consecutive attenders during the parent FEED study. While no pattern was evident in the FEED cohort, “normal day” CFS entries were more frequently missing with non-white ethnic group (76 %, vs 52 % with white group), self-presentation (68 %), and discharge home from ED (59 %). CFS distributions differed between the routine and research day datasets (p = 0.009).

Conclusion

Our findings suggest systematic, non-random omission of CFS in normal screening practice, disproportionately affecting people with non-white ethnic group and self-presentation. This raises concern for limitations when routine CFS data are analysed and prompts study and improvement of concordance with screening.

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欧洲急诊科（FEED）研究中衰弱与常规临床衰弱量表筛查的一致性

背景：衰弱筛查决定了谁接受老年急诊医学干预，这对患者的预后非常重要。然而，实施后的评估显示，大约50%的老年急诊科（ED）患者接受了筛查。为什么以及哪些人被排除在筛查之外，这在很大程度上仍未得到研究。本研究提供了将正常筛查状态与目标筛查研究数据进行比较的机会。方法：欧洲急诊科（FEED）的父母虚弱研究于2023年7月4日对连续的急诊科患者进行了临床虚弱量表（CFS）。本研究考虑了从两周前的“正常日子”提供可检索的CFS数据的站点子集。评估缺失CFS条目与观察变量的对称性和相关性。然后将脆弱性分布与母体FEED研究数据进行比较。结果：少数站点（5/62）以可检索格式记录CFS。在父母FEED研究中，55%的“正常日”CFS条目缺失，而14%的连续参与者缺失。虽然在FEED队列中没有明显的模式，但非白人组（76%，白人组为52%）、自我表现（68%）和从急诊室出院（59%）中，“正常日”的CFS条目更频繁地缺失。CFS分布在常规和研究日数据集之间存在差异（p = 0.009）。结论：我们的研究结果表明，在常规筛查实践中系统地、非随机地遗漏了CFS，对非白人群体和自我表现的影响不成比例。这引起了对常规CFS数据分析的局限性的关注，并促使研究和改进筛查的一致性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Emergency Nursing NURSING-

CiteScore

3.20

自引率

11.10%

发文量

期刊介绍： International Emergency Nursing is a peer-reviewed journal devoted to nurses and other professionals involved in emergency care. It aims to promote excellence through dissemination of high quality research findings, specialist knowledge and discussion of professional issues that reflect the diversity of this field. With an international readership and authorship, it provides a platform for practitioners worldwide to communicate and enhance the evidence-base of emergency care. The journal publishes a broad range of papers, from personal reflection to primary research findings, created by first-time through to reputable authors from a number of disciplines. It brings together research from practice, education, theory, and operational management, relevant to all levels of staff working in emergency care settings worldwide.