Association of Patient Reported Global Health Measures with Frailty Scores in Acutely Injured Older Adults.

Abstract

The older population is particularly vulnerable to traumatic injury. Frailty scores, used to estimate the physiologic status of an individual, are key to identifying those most at risk for injury. Global health measures such as the Veterans RAND 12 Item Health Survey (VR-12) are quality of life measures that assess older adults' overall perception of their health and may serve as a useful adjunct when predicting frailty. Herein, we evaluated whether components of the VR-12 correlated with worse frailty scores over time. Older adults (≥65) admitted to burn, trauma, or emergency general surgery services were prospectively enrolled. Demographics, frailty determined using the Trauma Specific Frailty Index (TSFI), and VR-12 surveys were collected at enrollment and 3, 6, 9, and 12-month follow-ups. A physical component score (PCS) and mental component score (MCS) was produced by VR-12 surveys for comparison purposes. Fifty-eight patients were enrolled, of which 8 died. No significant changes in PCS (p = 0.25) and MCS (p = 0.56) were observed over time. PCS (p = 0.97) and MCS (p = 0.78) at enrollment did not predict mortality. PCS (OR = 0.894 [0.84-0.95], p = 0.0004) and age (OR = 1.113 [1.012-1.223], p = 0.03) independently predicted enrollment frailty. These global measures of health could be utilized in lieu or in addition to frailty scores when assessing patients in the setting of acute injury. Studies are warranted to confirm this association.