Loss of Independence - a Rapid Alternative to Frailty Screening in a Swedish ED Setting

NCT04888884 | Completed

• 1 other identifier: 2021-00875LOI
• Study Type: observational
• Target: 1,800
• Locations: 1 country
• Sites: 3

Brief Summary

This prospective observational study will investigate the correlation of a surrogate marker of frailty in relation to serious outcomes. Serious outcomes are defined as: mortality within 30 days, admission to hospital, length of stay in the Emergency Department (ED), in-hospital Length of Stay and revisits to the ED. The exposure, frailty, will be assessed according to Loss of Independence (LOI) a possible low-cost quick tool to identify frailty in patients. The study population will be ED patients, \>65 years of age in a Swedish regional health care system (Region Östergötland, Sweden), comprising three EDs in Linköping, Norrköping and Motala. The outcomes will be compared according to the degree of frailty and censored over 7, 30 and 90 days.

Conditions

Frailty; Frailty Syndrome; Emergency Department; Geriatric Assessment

Outcome Measures

Primary Outcomes (1)

• Mortality in 30 Days

  Investigate level of mortality in cohort at 30 days

  All cause mortality up to 30 days from index visit

Secondary Outcomes (7)

• Mortality in 7 and 90 days

  All cause mortality up to 90 days from index visit

• Admission to hospital

  Hospital admission on index visit, censored at 90 days

• ED length of stay

  Length of stay at ED, censored at 4 days

• In-hospital length of stay

  In-hospital length of stay from index visit, censored at 90 days

• Revisits to the ED

  Number of newly registered visits to the ED after index visit, censored at 90 days

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients of all gender at the age of ≥ 65 years seeking medical care at the three EDs in Region Östergötland.

You may qualify if:

• ≥ 65 years
• able to answer questions to estimate frailty
• or have a proxy to answer questions

You may not qualify if:

• \<65 years
• unable to answer questions to estimate frailty

Sponsors & Collaborators

• University Hospital, Linkoeping: lead

Study Sites (3)

University Hospital Linköping

Linköping, Östergötland County, 58185, Sweden

Location

Medicinska Specialist Kliniken i Motala

Motala, Östergötland County, Sweden

Location

Vrinnevisjukhuset i Norrköping

Norrköping, Östergötland County, Sweden

Location

Related Publications (6)

• Kellett J, Deane B. The Simple Clinical Score predicts mortality for 30 days after admission to an acute medical unit. QJM. 2006 Nov;99(11):771-81. doi: 10.1093/qjmed/hcl112. Epub 2006 Oct 17.

  PMID: 17046859 BACKGROUND

• Kellett J, Deane B, Gleeson M. Derivation and validation of a score based on Hypotension, Oxygen saturation, low Temperature, ECG changes and Loss of independence (HOTEL) that predicts early mortality between 15 min and 24 h after admission to an acute medical unit. Resuscitation. 2008 Jul;78(1):52-8. doi: 10.1016/j.resuscitation.2008.02.011. Epub 2008 Apr 10.

  PMID: 18406038 BACKGROUND

• Brabrand M, Folkestad L, Clausen NG, Knudsen T, Hallas J. Risk scoring systems for adults admitted to the emergency department: a systematic review. Scand J Trauma Resusc Emerg Med. 2010 Feb 11;18:8. doi: 10.1186/1757-7241-18-8.

  PMID: 20146829 BACKGROUND

• Brabrand M, Lassen AT, Knudsen T, Hallas J. Seven-day mortality can be predicted in medical patients by blood pressure, age, respiratory rate, loss of independence, and peripheral oxygen saturation (the PARIS score): a prospective cohort study with external validation. PLoS One. 2015 Apr 13;10(4):e0122480. doi: 10.1371/journal.pone.0122480. eCollection 2015.

  PMID: 25867881 BACKGROUND

• Rylance J, Baker T, Mushi E, Mashaga D. Use of an early warning score and ability to walk predicts mortality in medical patients admitted to hospitals in Tanzania. Trans R Soc Trop Med Hyg. 2009 Aug;103(8):790-4. doi: 10.1016/j.trstmh.2009.05.004. Epub 2009 Jun 21.

  PMID: 19540542 BACKGROUND

• Berian JR, Mohanty S, Ko CY, Rosenthal RA, Robinson TN. Association of Loss of Independence With Readmission and Death After Discharge in Older Patients After Surgical Procedures. JAMA Surg. 2016 Sep 21;151(9):e161689. doi: 10.1001/jamasurg.2016.1689. Epub 2016 Sep 21.

  PMID: 27409710 BACKGROUND

MeSH Terms

Conditions

Frailty; Emergencies

Condition Hierarchy (Ancestors)

Pathologic Processes; Pathological Conditions, Signs and Symptoms; Disease Attributes

Study Officials

• Daniel Wilhelms, PhD

  Linkoeping University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: May 11, 2021
• First Posted: May 17, 2021
• Study Start: September 27, 2021
• Primary Completion: December 31, 2021
• Study Completion: December 31, 2021
• Last Updated: May 4, 2022

Record last verified: 2022-05

Data Sharing

• IPD Sharing: Will not share

Locations

SE (3)