Abstract
Background: Older individuals living with frailty face a heightened risk of experiencing significant deterioration in their mental and physical well-being following seemingly minor health challenges. Our aim was to assess and enhance the practice of the Clinical Frailty Scale (CFS) during inpatient assessments within a large teaching hospital.
Methods: We conducted 2 cycles of retrospective data collection within a single centre setting, screening a total of 600 patients focussing on; age ≥65, level of frailty, location of CFS assessment - Emergency Department (ED), Medical Assessment Unit (MAU); and the health-care professionals involved in CFS practice. We compared practices amongst young-old (65-74), middle-old (75-84), and old-old (≥ 85) age groups.
Results: The CFS documentation rate for eligible patients was 76.7% in the first cycle, involving 240 patients, and 83% in the second cycle which included 247 patients, whereas the rate for the above-mentioned age sub-groups was 13.8%, 67.7%, 98.3% respectively. The prevalence of frailty amongst the age sub-groups was 74.1%, 84.7%, and 93.9% respectively, while male-to-female prevalence was 88.9% and 89.2%. Overall, 72.7% of the CFS assessments were completed in ED. The Frailty Interface Team (FIT) significantly contributed to the CFS assessment by completing 58.1% of overall assessments.
Conclusion: The results underscore the significance of integrating frailty education into core teachings to enhance CFS practice among junior doctors. Identifying inpatient frailty in the 65-74 age group is crucial, as they are frailer than initially perceived and will further decline with aging. Interdisciplinary collaboration is essential, particularly a specialized FIT, proving pivotal in CFS practice within our hospital. Larger studies into inpatient frailty in the young-old age groups are recommended.