W. Rafaqat1, M. Abiad1, E. Lagazzi1, S. Ilkhani2, B. Grobman2, J. P. Herrera-Escobar2, A. Salim2, G. A. Anderson2, S. E. Sanchez3, H. M. Kaafarani1, J. O. Hwabejire1 1Massachusetts General Hospital, Boston, MA, USA 2Brigham And Women’s Hospital, Center For Surgery And Public Health, Boston, MA, USA 3Boston University, Chobanian And Avedisian School Of Medicine, Boston, MA, USA
Introduction: The incidence of severe injury in the geriatric population is increasing. However, the impact of frailty on long-term outcomes after injury in this population remains understudied. Therefore, we aimed to understand the impact of frailty on the long-term functional outcomes of severely injured geriatric patients.
Methods: We conducted a retrospective cohort study including patients ≥65 years with an injury severity score >15. Patients were contacted at 6- and 12-months post-injury and administered a validated trauma quality of life survey which assessed for the presence of functional limitations in the activities of daily living. We reviewed the patient’s medical records and the trauma registry for patient and injury characteristics. We defined frailty using the mFI5 validated frailty tool: patients with a score ≥2 out of 5 were considered frail. The impact of frailty on long-term functional outcomes was assessed using 1:1 propensity-matching adjusting for patient, injury, hospital complications, and discharge characteristics.
Results: We included 862 patients of whom 206 (23.9%) were frail. Frail patients were significantly older, and a greater proportion of patients were black and had blunt injury. In a propensity-matched sample of 152 pairs, frail patients reported significantly higher functional limitations than non-frail patients (57.2% vs. 45.4%; p=0.039). This difference was most prominent in the following activities: walking up stairs, walking on flat surfaces, and going to the bathroom. (Figure 1)
Conclusion: Frail geriatric patients with severe injury have worse long-term functional outcomes compared to non-frail patients. Geriatric trauma patients with high frailty may benefit from additional post-discharge rehabilitation services.
