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Frailty

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Geriatric Trauma and Critical Care

Abstract

An 81-year-old female falls at home, sustaining three rib fractures and a humerus fracture. She is awake and neurologically intact but having pain and dyspnea. Her family reports two falls in the recent past, neither requiring hospitalization. She has hypertension and diabetes and has had a prior hip replacement. She uses a beta blocker, long- and short-acting insulin, and a diuretic. Her family reports forgetfulness, anorexia, and 10-pound weight loss in the last 6 months and less interest in traveling outside the home. She’s admitted to the ICU where her oxygenation and urine output are marginal. She is assessed by physical and occupational therapy and found to have a Barthel index of 35/100 (indicating 65 % impairment of activities of daily living (ADLs) performance) and a trauma-specific frailty index of .48 (indicating high risk for discharge to a subacute nursing facility). A family meeting is held within 1 day of ICU admission to establish goals of care.

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Authors and Affiliations

  1. Division of General Surgery, Department of Surgery, University of Kentucky College of Medicine, Lexington, KY, USA

    Cynthia L. Talley MD & Andrew C. Bernard MD

  2. University of Kentucky, 800 Rose Street, C224, Lexington, KY, 40536-0298, USA

    Andrew C. Bernard MD

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  1. Department of Surgery, Stritch School of Medicine Loyola University of Chicago Edward Hines, Jr. Veterans Administration Medical Center, Maywood, Illinois, USA

    Fred A. Luchette

  2. Professor of Surgery, Hofstra School of Medicine Medical Director for Surgical and Perioperative Services, Southside Hospital/Northwell Health, Bay Shore, New York, USA

    Jay A. Yelon

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Talley, C.L., Bernard, A.C. (2017). Frailty. In: Luchette, F., Yelon, J. (eds) Geriatric Trauma and Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-319-48687-1_10

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