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A Frailty Screening Questionnaire (FSQ) to Rapidly Predict Negative Health Outcomes of Older Adults in Emergency Care Settings

  • Published:
The journal of nutrition, health & aging

Abstract

Background

Frailty, at the core of geriatric medicine, is an important concept underpinning health problems but the rapid and valid measurement of frailty for older adults in the Emergency Department (ED) is lacking in China. The Frailty Screening Questionnaire (FSQ), has been shown to be a simple, rapid and practical tool to identify frailty in both community and inpatients settings, yet its utility in acute care settings is not well understood.

Objective

To determine whether FSQ is useful to identify frailty and predict adverse outcomes in an emergency care setting.

Design and Participants

This prospective study included 350 adults aged 60 and over and admitted to the ED.

Measurements

The FSQ questionnaire which assessed self-reported slowness, weakness, inactivity, exhaustion, and weight loss was used to rapidly recognize frailty. FRAIL, Clinical frailty score (CFS), activities of daily living (ADL) and nutrition risk screening 2002 were also assessed. Outcome measures included all-cause 28-day mortality, ADL dependency, mechanical ventilation, length of hospital stay, and ICU readmissions 30 and 90 days after discharge. Cox proportional hazard model was used for survival comparison.

Results

The prevalence of FSQ frailty and prefrailty in older adults were 44.6% and 30.9% respectively in the emergency setting. FSQ frailty was associated with increasing age, chronic diseases, malnutrition risk, poor physical function and worse outcomes indicated by higher 28-d mortality, ADL dependency, mechanical ventilation, length of hospital stay, and ICU readmissions after discharge. The Kappa coefficient between the FSQ and FRAIL was 0.552. FSQ score was negatively correlated with grip strength and positively correlated with Barthel index, length of hospital stay and CFS score. Cox regression adjusted by epidemiological variables and chronic diseases showed FSQ and all components predicted mortality except weight loss.

Conclusion

The FSQ is a rapid and useful tool to screen frailty and an effective tool to predict mortality in busy emergency settings.

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Acknowledgments

We acknowledge all the people who participated in the study. Dr. Lina Ma would like to express special thanks to Dr. Jeremy Walston from Johns Hopkins University School of Medicine for his guidance and support in completing the project.

Funding

Funding: This work was supported by Beijing Natural Science Foundation (7202059), Beijing Municipal Administration of Hospitals Incubating Program (PX2020036) and Milstein Medical Asian American Partnership Foundation Project Award in Geriatrics (2018).

Author information

Authors and Affiliations

  1. Department of Emergency Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation, Beijing, 100020, China

    H. Liu & Shubin Guo

  2. Department of Emergency Medicine, Capital Medical University School of Rehabilitation Medicine, Beijing Bo’Ai Hospital, China Rehabilitation Research Center, Beijing, 100068, China

    H. Liu, N. Shang, L. Liu, W. Guo & P. Li

  3. Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China

    J. K. Chhetri & Lina Ma

Authors
  1. H. Liu
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  2. N. Shang
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  3. J. K. Chhetri
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  4. L. Liu
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  5. W. Guo
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  6. P. Li
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  7. Shubin Guo
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  8. Lina Ma
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Corresponding authors

Correspondence to Shubin Guo or Lina Ma.

Ethics declarations

Competing financial interests: The authors declare no competing financial interests.

Conflict of interest: None.

Ethical Standards: The present study followed the ethical guideline of the declaration of Helsinki and was approved by the Ethics committees.

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Liu, H., Shang, N., Chhetri, J.K. et al. A Frailty Screening Questionnaire (FSQ) to Rapidly Predict Negative Health Outcomes of Older Adults in Emergency Care Settings. J Nutr Health Aging 24, 627–633 (2020). https://doi.org/10.1007/s12603-020-1374-8

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  • DOI: https://doi.org/10.1007/s12603-020-1374-8

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