Frailty screening of older patients in emergency departments in Norway.

Abstract

Background: Frail older patients admitted to a hospital emergency department have a heightened risk of delirium, falls and death. No data exists on the prevalence of frailty in this patient group. The aim of this study was to map the incidence of frailty in older patients in two emergency departments in Norway.

Material and method: All patients aged ≥ 75 years who were admitted to an emergency department at the hospitals in Tønsberg and Tromsø in week 47 (20 November to 26 November) of 2023 were consecutively screened using the Clinical Frailty Scale (CFS). CFS scores indicate the level of frailty on a scale from 1 to 9. The patients were also assessed using the 4AT tool, where a score of ≥ 4 may indicate delirium.

Results: Among the 289 patients included (mean age 83 years; 54 % women), 66 % had a CFS score of ≥ 4 (frail), 54 % had a score of 4-6 (very mild to moderate frailty) and 12 % had a score above 7 (severe frailty). Among those classified as frail (CFS score 4-9), 35 % had a 4AT score ≥ 4, compared to 7 % among robust patients (CFS score 1-3).

Interpretation: A high proportion of patients aged ≥ 75 years admitted to two hospital emergency departments in Norway were categorised as frail. This is an important observation for the future optimisation of care pathways for older patients in emergency departments.