$Relationship between clinical outcomes and Dutch frailty score among elderly patients who underwent surgery for hip fracture$
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Relationship between clinical outcomes and Dutch frailty score among elderly patients who underwent surgery for hip fracture

AM Winters,1 LC Hartog,2 HIF Roijen,1 RM Brohet,3 AM Kamper1 1Department of Geriatrics, Isala, 8025 AB, Zwolle, the Netherlands; 2Diabetes Centre, Isala, 8025 AB, Zwolle, the Netherlands; 3Isala Academy, 8025 BP, Zwolle, the Netherlands Background: Frailty is a geriatric condition that is associat...

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Autores principales:	Winters AM, Hartog LC, Roijen HIF, Brohet RM, Kamper AM
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	Hip fracture Elderly Frailty Mortality Functional decline Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/3c2575d0af054027a83c91f98ac615d8
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spelling	oai:doaj.org-article:3c2575d0af054027a83c91f98ac615d82021-12-02T07:57:08ZRelationship between clinical outcomes and Dutch frailty score among elderly patients who underwent surgery for hip fracture1178-1998https://doaj.org/article/3c2575d0af054027a83c91f98ac615d82018-12-01T00:00:00Zhttps://www.dovepress.com/relationship-between-clinical-outcomes-and-dutch-frailty-score-among-e-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998AM Winters,1 LC Hartog,2 HIF Roijen,1 RM Brohet,3 AM Kamper1 1Department of Geriatrics, Isala, 8025 AB, Zwolle, the Netherlands; 2Diabetes Centre, Isala, 8025 AB, Zwolle, the Netherlands; 3Isala Academy, 8025 BP, Zwolle, the Netherlands Background: Frailty is a geriatric condition that is associated with an increased risk of mortality and functional decline. To date, mainly the Groningen Frailty Indicator (GFI) and Hospital Safety Management (VeiligheidsManagementSysteem [VMS]) frailty score are used to determine frailty in several hospitals in the Netherlands. However, it is yet unknown, which method has the best predictive value on clinical outcomes.Objective: The aim of this study was to investigate the predictive value of GFI and VMS on clinical outcomes among patients who underwent hip fracture surgery.Design: This is a prospective observational cohort study.Methods: We selected all patients aged 70 years or higher, who underwent hip fracture surgery in our general hospital, between November 2014 and November 2015. Among all patients, VMS, GFI and Barthel-20 index (BI) were assessed. McNemar’s paired test and Cohen’s κ were used to examine the difference and the level of agreement between the two scoring methods. Kaplan–Meier and multivariable regression analyses were performed to determine overall survival and mortality, respectively, 3 years and 30 days after surgery.Results: A total of 280 patients were included in the study. The median follow-up was 25 months. No systematic difference was found between the two methods (P=0.237), while a fair level of agreement could be measured (κ=0.363 [95% CI =0.23–50]). VMS showed a statistically significant difference in overall survival as compared to nonfrail patients (57 vs 80%, respectively [Plogrank <0.001] with an HR of 3.5 [95% CI =2.1–5.7; P<0.001]). Classification according to GFI yielded a lower but still significant HR 2.3 (95% CI =1.2–4.1; P=0.008).Conclusion: VMS can be used in classifying frailty, whereby VMS frailty score is associated with clinical outcomes as overall survival mortality in older patients with hip fracture and who underwent surgery.Keywords: orthopedic surgery, frailty assessment, geriatric patients, mortality, functional decline Winters AMHartog LCRoijen HIFBrohet RMKamper AMDove Medical PressarticleHip fractureElderlyFrailtyMortalityFunctional declineGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 13, Pp 2481-2486 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Hip fracture Elderly Frailty Mortality Functional decline Geriatrics RC952-954.6
spellingShingle	Hip fracture Elderly Frailty Mortality Functional decline Geriatrics RC952-954.6 Winters AM Hartog LC Roijen HIF Brohet RM Kamper AM Relationship between clinical outcomes and Dutch frailty score among elderly patients who underwent surgery for hip fracture
description	AM Winters,1 LC Hartog,2 HIF Roijen,1 RM Brohet,3 AM Kamper1 1Department of Geriatrics, Isala, 8025 AB, Zwolle, the Netherlands; 2Diabetes Centre, Isala, 8025 AB, Zwolle, the Netherlands; 3Isala Academy, 8025 BP, Zwolle, the Netherlands Background: Frailty is a geriatric condition that is associated with an increased risk of mortality and functional decline. To date, mainly the Groningen Frailty Indicator (GFI) and Hospital Safety Management (VeiligheidsManagementSysteem [VMS]) frailty score are used to determine frailty in several hospitals in the Netherlands. However, it is yet unknown, which method has the best predictive value on clinical outcomes.Objective: The aim of this study was to investigate the predictive value of GFI and VMS on clinical outcomes among patients who underwent hip fracture surgery.Design: This is a prospective observational cohort study.Methods: We selected all patients aged 70 years or higher, who underwent hip fracture surgery in our general hospital, between November 2014 and November 2015. Among all patients, VMS, GFI and Barthel-20 index (BI) were assessed. McNemar’s paired test and Cohen’s κ were used to examine the difference and the level of agreement between the two scoring methods. Kaplan–Meier and multivariable regression analyses were performed to determine overall survival and mortality, respectively, 3 years and 30 days after surgery.Results: A total of 280 patients were included in the study. The median follow-up was 25 months. No systematic difference was found between the two methods (P=0.237), while a fair level of agreement could be measured (κ=0.363 [95% CI =0.23–50]). VMS showed a statistically significant difference in overall survival as compared to nonfrail patients (57 vs 80%, respectively [Plogrank <0.001] with an HR of 3.5 [95% CI =2.1–5.7; P<0.001]). Classification according to GFI yielded a lower but still significant HR 2.3 (95% CI =1.2–4.1; P=0.008).Conclusion: VMS can be used in classifying frailty, whereby VMS frailty score is associated with clinical outcomes as overall survival mortality in older patients with hip fracture and who underwent surgery.Keywords: orthopedic surgery, frailty assessment, geriatric patients, mortality, functional decline
format	article
author	Winters AM Hartog LC Roijen HIF Brohet RM Kamper AM
author_facet	Winters AM Hartog LC Roijen HIF Brohet RM Kamper AM
author_sort	Winters AM
title	Relationship between clinical outcomes and Dutch frailty score among elderly patients who underwent surgery for hip fracture
title_short	Relationship between clinical outcomes and Dutch frailty score among elderly patients who underwent surgery for hip fracture
title_full	Relationship between clinical outcomes and Dutch frailty score among elderly patients who underwent surgery for hip fracture
title_fullStr	Relationship between clinical outcomes and Dutch frailty score among elderly patients who underwent surgery for hip fracture
title_full_unstemmed	Relationship between clinical outcomes and Dutch frailty score among elderly patients who underwent surgery for hip fracture
title_sort	relationship between clinical outcomes and dutch frailty score among elderly patients who underwent surgery for hip fracture
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/3c2575d0af054027a83c91f98ac615d8
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Relationship between clinical outcomes and Dutch frailty score among elderly patients who underwent surgery for hip fracture

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