Does the Clinical Frailty Scale predict re-presentations to the ED in elderly community-dwelling people following an initial presentation from a fall?

Grant ID: EMEG-001R36-2021-BARTON

Project Summary

Falls in the elderly community-dwelling population are a common presentation to Australian Emergency Departments (ED). The Australian Institute of Health and Welfare reported an estimated 125,000 people aged 65+ were hospitalised due to falls in 2016/17. Fallers presenting to the ED that are elderly and frail, may then be discharged directly home.

The Clinical Frailty Scale (CFS) has been widely used and is associated with mortality, comorbidity, increased length of stay and falls (Church 2020). Despite its expansive utilisation, no studies have assessed the correlation of CFS scores with re-presentation to the ED following a fall.

Improving the ability to identify patients who are at risk of re-presenting with falls could aid in focusing physiotherapy and allied health resources towards these patients during their initial ED presentation.

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Outcomes

This study reviewed ED presentations and CFS to Metro South hospitals between July 2019 and July 2022. 652 index fall related presentations were identified, approximately 9% of patients re-presented with a new fall within 6 months of index fall. There was a significant relationship between increasing CFS and mortality and representations for new falls, however the relationship is not strong enough to predict which individuals are at highest risk of representation.

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Dissemination

Presentations:

- Barton, L., Clinical Frailty Scale provides negligible clinical benefit in predicting Emergency Department re-presentations following an initial visit for a fall. Australian Physiotherapy Association 2023 Ignite Conference, 6 October 2023.

- Barton, L., Physiotherapy Led Review of Quality of Care of Accidental Falls and Correlation of the Clinical Frailty scale with re-presentation rates. QEII Allied Health Symposium, 13 June 2023.

- Barton, L., Physiotherapy review of quality of care of elderly falls and correlation of the clinical frailty scale with re-presentations after a fall. QEII Research Symposium, 13 May 2023.

- Barton, L., Does the Clinical Frailty Scale predict re-presentations to the Emergency Department in elderly community-dwelling people following a fall? Queensland Emergency Department Physiotherapy Network Conference, 21 April 2023.

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