139 Emerging trends in the Emergency Department of a level three hospital using the Clinical Frailty Scale

Abstract

Abstract Background The Clinical Frailty Scale (CFS) is a highly regarded and well validated diagnostic instrument used to measure frailty in older adults in the emergency department (ED). The purpose of this review is to highlight emerging trends between the CFS and length of stay (LoS) in older adults in a level three hospital over a 2 year period. Methods We performed a systematic literature review to identify research that used the CFS in the ED. In conjunction with the literature, we completed a retrospective data analysis of patients over 75 admitted and discharged within a 2 year period. A comparison was made with patients reviewed by the Frailty Intervention Therapy Team (FITT) who received an interdisciplinary assessment. Results Over a 2 year period, 11, 961 patients over 75 years were triaged in the ED and 3,076 (26%) of these patients were assessed by the FITT. The average length of stay (LOS) for patients assessed by the FITT was 6.8 days in 2021 and 6.6 days in 2022. This is significantly lower than the hospital average for over 75 years (10 days). On closer review, it was apparent that patients scoring a CFS of 6 had a direct correlation with longer length of stay. In 2021 and 2022, a patient with a CFS 6 had a 10 day LOS, CFS 5 had an 8 day average and CFS 4 had a 5 day average. In addition, CFS 6 presentations were notably climbing. 13% of patients assessed in 2021 scored a CFS 6 (143). This rose sharply in 2022 to 24% (473). Conclusion Our results are consistent with other well documented studies on the relationship between CFS and increased LOS. The increase in presentations of patients with a CFS6 will increase demand on EDs; increase inpatient bed days and inevitably the associated cost and resource implications on the acute sector.