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Completed

NCT Number: NCT04877028

Frailty Screening in the Swedish Emergency Department Setting

This prospective observational study will investigate the correlation 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 Clinical Frailty Scale. 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 respectively.

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Key information

Age range

65 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

University Hospital Linköping

Linköping, Östergötland County, 58185, Sweden

About this study

Frailty is a common clinical syndrome in older adults that carries an increased risk for poor health outcomes including falls, incident disability, hospitalization, and mortality.

The clinical frailty scale (CFS) is a measure of frailty based on clinical judgement in a 9 level scale, categorized as "vulnerable" (1-4), "mildly frail" (5), moderatly frail (6) and severely and very severely frail (7-8).". A validation study of the CFS in community-dwelling older people showed that it performed better than measures of cognition, function or comorbidity in assessing risk for death. In a prospective observational study including consecutive ED patients aged 65 years or older The Hosmer-Lemeshow test indicated a good agreement between predicted probability and observed frequency of 30-day mortality and ICU admission.

The aim of this study will be to investigate if the fraily, assessed according to CFS, is associated with increased 30-day mortality. in a Swedish Emergency Care context. Secondary outcomes included 7-and 90-day mortality, ED length of stay, hospital admission, hospital length of stay, subsequent falls and medication changes. Additionally, we collect data on morbidity and comorbidities to assess the association with the level of frailty. Since this is a multicenter study, possible geographic differences will be studied as well. Based on the results of this study, possible interventions could be identified to improve the care of the frail geriatric patients presenting at the ED.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • ≥65 years, able to answer any questions, alternatively have a proxy

Exclusion criteria

  • Patients: <65 years

Treatment and study plan

Primary outcomes

  1. Mortality in 30 days

    Time frame: All cause mortality up to 90 days from index visit

    Investigate level of mortality in cohort at 30 days

Secondary outcomes

  1. Mortality in 7 and 90 days

    Time frame: All cause mortality up to 90 days from index visit

    Investigate level of mortality in cohort at 7 and 90 days

  2. Admission to hospital

    Time frame: Hospital admission on index visit, censored at 90 days

    Investigate level of all cause admissions in cohort

  3. ED length of stay

    Time frame: Length of stay at ED, censored at 4 days

    Investigate length of stay at ED

  4. Hospital length of stay

    Time frame: Hospital length of stay from index visit, censored at 90 days

    Investigate hospital length of stay

  5. Revisitis to the ED

    Time frame: Number of newly registered visits to the emergency department after index visit, censored at 90 days

    Number of newly registered visits to the emergency department after index visit

  6. Fall prevalence after the index visit

    Time frame: Falls that resulted in further ED visits after index visit, censored in 90 days

    Falls that resulted in further ED visits

  7. Alterations in medication during the visit (based on codes for Anatomical, Therapeutic, Chemical classification (ATC-code))

    Time frame: Alterations in medications from index visit and during the follow-up period, censored at 90 days

    Alterations in medication and during the follow-up period

Sponsors and collaborators

Lead sponsor

University Hospital, Linkoeping

Other

Registry information

Important dates

Study start
2021
Primary completion
2021
Study completion
2021
First posted
May 7, 2021
Registry last updated
Jun 23, 2022

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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