TY - JOUR
T1 - Prospective evaluation of health-related quality of life in geriatric trauma patients
AU - Santino, Chelsey
AU - Zeeshan, Muhammad
AU - Hamidi, Mohammad
AU - Hanna, K.
AU - Saljuqi, Abdul Tawab
AU - Kulvatunyou, Narong
AU - Haddadin, Zaid
AU - Northcutt, Ashley
AU - Joseph, Bellal
N1 - Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2019/9
Y1 - 2019/9
N2 - Background: Frailty is an established predictor of adverse outcomes in geriatric patients. Health-related quality of life (HRQoL) is an important outcome measure among trauma patients. This prospective observational study examined the impact of frailty on health-related quality of life in geriatric trauma patients. Methods: We prospectively enrolled geriatric (age ≥65 years) trauma patients. We calculated the frailty index (FI) within 24 hours of admission using the trauma-specific frailty index. Patients were stratified into frail (frailty index ≥0.27) and nonfrail (frailty index <0.27). Health-related quality of life was calculated at discharge and at 30 days (day) after discharge using the RAND Short Form-36 (SF-36). Outcome measures were health-related quality of life at discharge, 30-days postdischarge, and delta health-related quality of life. Regression analysis was performed to control for demographic, vital signs, and injury parameters. Results: We enrolled 296 patients. The mean age was 75.1 ± 9.8 years, 59% were male, and 81% were white. Frail patients accounted for 34%, and they had a lower health-related quality of life at discharge (366 vs 548, P < .01) and at 30-day postdischarge (393 vs 744, P < .01). Nonfrail patients scored higher in 6 out of 8 domains of health-related quality of life. Nonfrail patients had improved delta health-related quality of life (P < .01), unlike frail patients (P = .11). A linear regression model revealed an inverse relationship between frailty and improvement in health-related quality of life over 30-day postdischarge (β = –0.689, [confidence interval, –0.963 to –0.329] P = .01). This association remained statistically significant after controlling for potential confounding covariates, such as age, sex, race, and injury severity. Conclusion: Compared with nonfrail geriatric trauma patients, those who were frail had poor health-related quality of life at discharge and at 30-day postdischarge. Frailty negatively affects the recovery of health-related quality of life after trauma. The use of frailty indices may help identify and develop targeted interventions to improve health-related quality of life among geriatric trauma patients.
AB - Background: Frailty is an established predictor of adverse outcomes in geriatric patients. Health-related quality of life (HRQoL) is an important outcome measure among trauma patients. This prospective observational study examined the impact of frailty on health-related quality of life in geriatric trauma patients. Methods: We prospectively enrolled geriatric (age ≥65 years) trauma patients. We calculated the frailty index (FI) within 24 hours of admission using the trauma-specific frailty index. Patients were stratified into frail (frailty index ≥0.27) and nonfrail (frailty index <0.27). Health-related quality of life was calculated at discharge and at 30 days (day) after discharge using the RAND Short Form-36 (SF-36). Outcome measures were health-related quality of life at discharge, 30-days postdischarge, and delta health-related quality of life. Regression analysis was performed to control for demographic, vital signs, and injury parameters. Results: We enrolled 296 patients. The mean age was 75.1 ± 9.8 years, 59% were male, and 81% were white. Frail patients accounted for 34%, and they had a lower health-related quality of life at discharge (366 vs 548, P < .01) and at 30-day postdischarge (393 vs 744, P < .01). Nonfrail patients scored higher in 6 out of 8 domains of health-related quality of life. Nonfrail patients had improved delta health-related quality of life (P < .01), unlike frail patients (P = .11). A linear regression model revealed an inverse relationship between frailty and improvement in health-related quality of life over 30-day postdischarge (β = –0.689, [confidence interval, –0.963 to –0.329] P = .01). This association remained statistically significant after controlling for potential confounding covariates, such as age, sex, race, and injury severity. Conclusion: Compared with nonfrail geriatric trauma patients, those who were frail had poor health-related quality of life at discharge and at 30-day postdischarge. Frailty negatively affects the recovery of health-related quality of life after trauma. The use of frailty indices may help identify and develop targeted interventions to improve health-related quality of life among geriatric trauma patients.
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U2 - 10.1016/j.surg.2019.04.031
DO - 10.1016/j.surg.2019.04.031
M3 - Article
C2 - 31235245
AN - SCOPUS:85067491814
SN - 0039-6060
VL - 166
SP - 403
EP - 407
JO - Surgery (United States)
JF - Surgery (United States)
IS - 3
ER -