Retrospective Use of the Pictorial Fit-Frail Scale for Determination of Frailty Level in Hospitalized Older Adults with a Hip Fracture

Frailty can lead to an increased risk of adverse health outcomes, higher rates of complications, and falls in older adults/12) These falls can result in hip fractures, which are more likely to occur in frail older adults/3) Currently, over 1.6 million Canadians over the age of 65 are living with frailty, and by 2030, this number is expected to rise to 2.5 million/4) Research has shown that 21% of adults aged 65 or older hospitalized in New Brunswick were categorized as frail based on administrative data/5) With an aging population, understanding frailty and how it impacts health outcomes is important. Several tools exist to measure frailty, such as the Clinical Frailty Scale/6) the Frailty Index/7) and the Frailty Phenotype/89) A scoping review of the literature demonstrated that determining frailty in hospitalized patients is often difficult/10) Other frailty assessment tools have been used with electronic health records (EHRs), such as the electronic frailty index, which incorporates 36 health deficits to determine the frailty level of older adults from primary care EHRs in the United Kingdom/11) The Pictorial Fit-Frail Scale (PFFS) is a frailty tool consisting of visual images to assess frailty across 14 domains that can be completed by health professionals, patients, or caregivers/12) This tool enables the assessment of older adults regardless of communication barriers, frailty severity, health literacy status, cognitive ability, or the lack of time and/or trained professionals/12) The objective of this study was to explore the feasibility of using the PFFS in determining a patient's frailty level through a retrospective review of hospital EHRs for older adults admitted with a hip fracture. Participants were sampled chronologically with every fourth patient being included in this frailty assessment. [...]this sample of 200 was a randomized sample of all isolated hip fracture patients admitted to one hospital over a four-year time frame and represents almost 30% (29.3%) of the entire sample of 682. Ten had four or more missing domains, and one had not been admitted to the hospital. [...]the sample size of 189 older adults was used for analysis.