PHYSICAL FRAITY AND ONE-YEAR READMISSIONS AMONG GERIATRIC TRAUMA PATIENTS

Background: An understanding of acute care readmissions among older adults informs quality improvement efforts and guides policy initiatives. Among geriatric trauma patients (GTPs), studies examining one-year readmissions have been confined to retrospective analyses of trauma registry data and/or large state-wide discharge data. We conducted a prospective cohort study among GTPs who remained alive at four time points over one year, and examined all causes of readmissions, repeat readmissions, and pre-injury frailty status. We hypothesized that pre-injury physical frailty would predict readmissions among GTPs. Methods: Sample: 188 adults >/= age 65 admitted to a level one trauma center over a six month period (Oct2013-Mar2014) with a primary injury. Pre-injury physical frailty measures were obtained on admission from surrogate respondents. Procedure: After hospitalization, home phone calls were made to patients or surrogates at 30, 90, 180 and 360 days. Data Analysis: Frequency distributions, logistic regression models. Results: Over a 1-year period, 46 patients (25%) died and 55 patients (40%) still living at 4 time points experienced one or more readmissions, for a total of 125 readmissions. Seventeen patients (31%) had > 1 readmission prior to death or within 1-year. Reasons for readmission included: follow-up surgeries (30%), medical complications (28%), medical comorbidities (22%), and repeat falls (9%). After controlling for age, comorbidites, injury severity, pre-injury frailty and cognitive impairment, pre-injury frailty status was the only statistically significant predictor of at least 1 readmission