Abstract
Background Clinicians are increasingly aware of the association of frailty syndrome and adverse outcomes. The British Geriatric Society recommends that clinical frailty scores (CFS) are assessed for all patients on admission to surgery, to optimise peri-operative care.
Method For in-patients over one month (June 2023), the concordance with guidelines was recorded and any ‘missing’ scores retrospectively completed (Rockwood CFS). Clinical metrics included length of stay.
Results 110 patients were admitted under vascular surgery. The median age was 67 (IQ 61-79). 73 (66%) were aged >65-years and 42 (58%) of these patients were frail or at risk of frailty (CFS 4-9); 37% of all admissions. 10 (14%) patients >65-years had their CSF documented, only 3 (4%) had this documented in an easy-to-access “AdHoc” form. 3 frail patients had formal assessment by a geriatrician during admission. Higher frailty score directly correlated with longer hospital admission (p=0.002), the average stay was 4 days longer in the frail cohort.
Conclusion Despite the high prevalence of frailty among vascular admissions, the overwhelming majority did not have CFS scores recorded in line with BGS Guidance, perhaps increasing risks for these patients. Ongoing quality improvement has focussed on educating foundation staff responsible for clerking surgical patients on the importance of assessing and documenting CFS.
Comments
Too easily missed
So important to get a frailty score on admission - has an enormous impact on the day to day nursing of a patient if we know what baseline we're trying to rehabilitate them in days of recovery. Thank you