Accès ouvert déclaré
2020
article
Association between preadmission frailty and care level at discharge in older adults undergoing emergency laparotomy
Ben Carter, Jennifer Law, Jonathan Hewitt, Kat Parmar, J M Boyle, Patrick Casey, Ishaan Maitra, Lyndsay Pearce, Susan Moug, Bryony Ross, Julia Oleksiewicz, Nicola Fearnhead, Christopher Jump, Jemma Boyle, Alex Shaw, Jonathan Barker, Jane Hughes, Jonathan Randall, Isileli Tonga, James Kynaston, Matthew Boal, Nicola Eardley, Elizabeth Kane, Harriet Reader, S Roy Mahapatra, Michael Garner-Jones, Jessica Tan, Said Mohamed, Rina George, Ed Whiteman, Kamran Malik, Christopher J. Smart, M Bogdan, Madhu Chaudhury, Videha Sharma, D. Subar, Panna Patel, Sok-Moi Chok, E.J. Lim, Vedamurthy Adhiyaman, Glesni Davies, Ellen Ross, Rudra Maitra, Colin W. Steele, Campbell Roxburgh, Shelly Griffiths, Natalie Blencowe, Emily Kirkham, John S. Abraham, Kirsty Griffiths, Yasser Abdulaal, Muhammad Rafaih Iqbal, Munir Tarazi, James Hill, Azam Khan, Ian Farrell, Gemma Conn, Jugal Patel, Hyder Reddy, J Sarveswaran, Lakshmanan Arunachalam, Afaq Malik, Luca Ponchietti, Krystian Pawelec, Yan Mei Goh, Parveen Vitish‐Sharma, Ahmed Saad, Edward Smyth, Amy Crees, Louise Merker, Nahida Bashir, Gethin Williams, Jennifer Hayes, Kelly Walters, Rhiannon Harries, Rahulpreet Singh, N. Henderson, Francesco M. Polignano, Ben Knight, Louise Alder, Alexandra Kenchington, Yan Li Goh, Ilaria Dicurzio, Ewen Griffiths, Ahmed Alani, Katrina Knight, Patrick MacGoey, Guat Shi Ng, Naomi Mackenzie, Susan Moug, Kelly Ong, Daniel McGrath, Emanuele Gammeri, Guillame Lafaurie, G Faulkner, Gabriele Di Benedetto, Julia McGovern, Bharathi Subramanian, Sunil K. Narang, J. Nowers, Neil Smart, I. R. Daniels, M Varcada, Tanzeela Gala, Julie Cornish, Zoe Barber, Stephen O’Neill, Richard McGregor, Andrew G Robertson, Simon Paterson-Brown, Thomas Raymond, Mohamed A. Thaha, William English, Cillian T. Forde, Heidi Paine, Alpa Morawala, Ravindra Date, Patrick Casey, Thomas Bolton, Xuan Gleaves, Joshua Fasuyi, Sanja Durakovic, Matt Dunstan, Sophie Allen, Angela Riga, Jonathan Epstein, Lyndsay Pearce, Emily Gaines, Anthony Howe, Halima Choonara, Ffion Dewi, Joanne Bennett, Emile King, Kathryn Mccarthy, Greg Taylor, Dean Harris, Hari Nageswaran, Amy Stimpson, Kamran Siddiqui, Lay In Lim, Christopher Ray, Laura Smith, Gillian McColl, Mohammed Rahman, Aaron Kler, Abhi Sharma, Kat Parmar, Neil Patel, Perry Crofts, Claudio Baldari, Rhys Thomas, Michael Stechman, Roland Aldridge, James O’Kelly, Graeme Wilson, Nicholas Gallegos, R Kalaiselvan, R Rajaganeshan, Aliya Mackenzie, Prashant Naik, Kaushiki Singh, Harinath Gandraspulli, Jeremy Wilson, Kate Hancorn, Amir Khawaja, Felix Nicholas, Thomas Marks, Cameron Abbott, Susan M. Chandler
52Citations signalées — pas une note de qualité
10Institutions déclarées
1Pays d’affiliation déclarés
Résumé fourni par la source
BACKGROUND: Older adults undergoing emergency abdominal surgery have significantly poorer outcomes than younger adults. For those who survive, the level of care required on discharge from hospital is unknown and such information could guide decision-making. The ELF (Emergency Laparotomy and Frailty) study aimed to determine whether preoperative frailty in older adults was associated with increased dependence at the time of discharge. METHODS: The ELF study was a UK-wide multicentre prospective cohort study of older patients (65 years or more) undergoing emergency laparotomy during March and June 2017. The objective was to establish whether preoperative frailty was associated with increased care level at discharge compared with preoperative care level. The analysis used a multilevel logistic regression adjusted for preadmission frailty, patient age, sex and care level. RESULTS: A total of 934 patients were included from 49 hospitals. Mean(s.d.) age was 76·2(6·8) years, with 57·6 per cent women; 20·2 per cent were frail. Some 37·4 per cent of older adults had an increased care level at discharge. Increasing frailty was associated with increased discharge care level, with greater predictive power than age. The adjusted odds ratio for an increase in care level was 4·48 (95 per cent c.i. 2·03 to 9·91) for apparently vulnerable patients (Clinical Frailty Score (CFS) 4), 5·94 (2·54 to 13·90) for those mildly frail (CFS 5) and 7·88 (2·97 to 20·79) for those moderately or severely frail (CFS 6 or 7), compared with patients who were fit. CONCLUSION: Over 37 per cent of older adults undergoing emergency laparotomy required increased care at discharge. Frailty scoring was a significant predictor, and should be integrated into all acute surgical units to aid shared decision-making and discharge planning.
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Contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Association between preadmission frailty and care level at discharge in older adults undergoing emergency laparotomy
- Date Crossref
- 10/01/2020
- Éditeur
- Oxford University Press (OUP)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude et ne compte pas comme une seconde source scientifique indépendante.
Institutions déclarées
Une affiliation ne permet pas de déduire la nationalité d’un auteur.
Sujets associés
Frailty in Older AdultsCardiac, Anesthesia and Surgical OutcomesHip and Femur Fractures