Aim We aimed to review the prevalence, clinical presentations and outcomes of frail versus non-frail patients in a MAU cohort.
Methods We performed a prospective observational study of patients admitted to the MAU from June to August 2021, and April to July 2022 (interruption due to COVID-19). Demographic, clinical data, Clinical Frailty Scale (CFS), Charlson comorbidity score were obtained from review of the medical record. Frailty was defined as CFS > 5. Analysis of categorical data was performed using chi-squared tests, and t-test or Mann-Whitney U tests for comparison of continuous variables.
Results There was a total of 356 patients in the study period with 68% (n=241) classified as frail, 49% male and 15% from a residential aged care facility. Frail patients were older (median age 84 years) compared to non-frail patients (70 years) (p<0.001). A greater proportion of patients who were frail presented following a fall (30%) compared to non-frail (18%) (p=0.02) and were more likely to present with delirium (9% v 1%, p=0.004). Frail patients had a higher Charlson Comorbidity index (2.2 vs 1.5, p=0.01). Frailty was associated with greater risk of overall inpatient complications compared to non-frail patients (RR 2.8 (95% CI 1.7-4.6, p=0.001), delirium (RR 4.9 (95%-CI 1.9-12.9, p=<0.001), and greater length of stay (14 + 14 vs 9 + 11 days, p=0.001).
Conclusion Frailty is prevalent in the MAU and is associated with presentations with geriatric syndromes including falls and delirium, and are at increased risk of inpatient complications and increased length of stay.