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Current Gerontology and Geriatrics Research
Volume 2014 (2014), Article ID 357857, 8 pages
http://dx.doi.org/10.1155/2014/357857
Research Article

Effect of Frailty on Functional Gain, Resource Utilisation, and Discharge Destination: An Observational Prospective Study in a GEM Ward

1Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, WA 6009, Australia
2Osborne Park Hospital, Osborne Place, Stirling, WA 6021, Australia
3The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia

Received 30 July 2013; Revised 25 September 2013; Accepted 27 September 2013; Published 17 February 2014

Academic Editor: Francesc Formiga

Copyright © 2014 Sujatha Kawryshanker et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. A geriatric evaluation and management unit (GEM) manages elderly inpatients with functional impairments. There is a paucity of literature on frailty and whether this impacts on rehabilitation outcomes. Objectives. To examine frailty score (FS) as a predictor of functional gain, resource utilisation, and destinations for GEM patients. Methods. A single centre prospective case study design. Participants ( ) were ≥65 years old and admitted to a tertiary hospital GEM. Five patients were excluded by the preset exclusion criteria, that is, medically unstable, severe dementia or communication difficulties after stroke. Core data included demographics, frailty score (FS), and functional independence. Results. The mean functional improvement (FIM) from admission to discharge was 11.26 (95% CI 8.87, 13.66; ). Discharge FIM was positively correlated with admission FIM ( ; ) and negatively correlated with frailty score ( ; ). The majority of the patients were in the “frail” group. “Frail” and “severely frail” subgroups improved more on mean FIM scores at discharge, relative to that experienced by the “pre-frail” group. Conclusion. All patients experienced functional improvement. Frailer patients improved more on their FIM and improved relatively more than their prefrail counterparts. Higher frailty correlated with reduced independence and greater resource utilisation. This study demonstrates that FS could be a prognostic indicator of physical independence and resource utilisation.