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Multicenter Study
. 2021 Apr 30;16(4):e0250803.
doi: 10.1371/journal.pone.0250803. eCollection 2021.

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

Timothy Xin Zhong Tan  1 , Nivedita V Nadkarni  2 , Wei Chong Chua  3 , Lynette Ma Loo  4 , Philip Tsau Choong Iau  4 , Arron Seng Hock Ang  5 , Jerry Tiong Thye Goo  6 , Kim Chai Chan  7 , Rahul Malhotra  8 , Marcus Eng Hock Ong  8   9 , David Bruce Matchar  8 , Dennis Chuen Chai Seow  10 , Hai V Nguyen  11 , Yee Sien Ng  12 , Angelique Chan  13 , Ting-Hway Wong  8   14
Affiliations
Multicenter Study

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

Timothy Xin Zhong Tan et al. PLoS One. .

Abstract

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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Conflict of interest statement

One or more of the authors are employed by SingHealth Services. This does not alter our adherence to PLOS ONE policies on sharing data and materials. The undersigned authors declare that they have otherwise no financial or personal conflicts of interest to declare.

Figures

Fig 1
Fig 1. Participant recruitment flowchart.
See this image and copyright information in PMC

References

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