Relationship between frailty and discharge outcomes in subacute care.

Aims: To determine whether level of frailty can predict length of stay, discharge destination, level of participation in physiotherapy, and degree of physical improvement with physiotherapy in older, subacute hospital patients.

Method: The Edmonton Frail Scale (EFS) was administered to 75 older people in a subacute hospital setting. Relationships between EFS score and a range of other measures, including participation in physiotherapy, Elderly Mobility Scale, discharge destination and length of stay, were examined.

Results: Level of frailty did not predict length of stay (rho=-0.13, P=0.24), discharge destination (t=-1.32, P=0.19), raw change on the Elderly Mobility Scale (rho=0.06, P=0.61) or rate of change on the Elderly Mobility Scale (r=-0.001, P=0.98). In addition, participants with a high level of frailty were more likely to achieve a satisfactory level of participation in physiotherapy sessions than those with low frailty (OR 1.43, P=0.02).

Conclusion: Level of frailty measured with the EFS was not a useful predictor of rehabilitation and discharge outcomes for older people in subacute care. These results do not support the routine use of the EFS to measure frailty in subacute care. WHAT IS KNOWN ABOUT THIS TOPIC? In a community-dwelling population, level of frailty has been found to predict poor outcomes from surgery, falls, fractures, disability, need for residential care and mortality. However, little is known about the impacts of frailty in a subacute setting, nor how frailty could best be measured in this setting. WHAT DOES THIS PAPER ADD? The use of the EFS as a predictive tool was not supported by the results of this exploratory study. WHAT ARE THE IMPLICATIONS FOR PRACTITIONERS? Alternative frailty measures may be more suitable than the EFS for patients in a subacute setting.