1. Alan J Poots1, Derryn Lovett1,2, John Soong1, Derek Bell1,2
R29 QUANTIFYING THE PREVALENCE OF FRAILTY IN SCOTTISH HOSPITALS USING GERIATRIC SYNDROMES: A REPLICATION STUDY
Alan J Poots1, Derryn Lovett1,2, John Soong1, Derek Bell1,2
1 CLAHRC NWL/ Imperial College, 2 Chelsea and Westminster Hospital NHS FT
Aims
Agedness and frailty are increasing in England [1].
We seek to determine the feasibility of using a model of frailty developed in England based on “geriatric syndromes” [1] to quantify the prevalence of frailty in Scottish hospitals, and examine difference.
Methods
Study sample: patient admission spells in general or acute hospitals completed between 01 April 2014 and 31 March 2015, recorded in national Scottish Morbidity Records (SMR01). Activity includes acute hospital admissions only, excluding mental health or long-term geriatric episodes.
Presence of geriatric syndromes assigned through coding of admission reason (Figure 1).
Descriptive statistics are given, and a comparison of frailty prevalence made by chi-square test.
Outcomes / Results
The study was able to part-replicate the English studies, with analysis by syndrome still to be achieved as we investigate coding performance.
There were 508,505 admissions for o65s, and of these were 76,023 “frail” admissions (Figure 2).
Spatial analysis maps Scotland’s o65 Continuous Inpatient Stays (CISs), and the percentage of those CISs with at least one syndrome, i.e. were frail (Figure 3 and 4)
The English study found a “frailty” prevalence of 13.9% ( ) [1], significantly lower than the 14.9% found in Scotland (p<0.001).
Conclusion
Replication of quantification of frailty by administrative data was possible, with the available coding for diagnosis being 6 fields within each SMR episode, compared to the 20 available in the English study.
However, ICD-10 codes are currently truncated at 3 characters until a review of how the more detailed codes are used in Scotland.
The prevalence of frailty determined in Scotland was higher than in the England study
However, the data periods are not the same and the English study determined a rising trend, thus this might not be a true difference. Further, that the unit of analysis, CIS is not directly comparable to the HES data 'spell' so comparisons should be made with caution.
These findings give expectations of presenting complaints, and can help to plan configuration of service when associated with geo-spatial information, and give insight to likely incoming acuity.
References
[1] Soong et al. Quantifying the prevalence of frailty in English hospitals. BMJ Open doi: /bmjopen
Acknowledgements
Thanks for the contribution from NHS National Services Scotland
Figure 1. Conceptualisation of Frailty: admission codes for any of these reasons is considered “frail”
Figure 3 Over 65yo Continuous Inpatient Stays (CISs) in Scotland
Falls and Fractures
FRAILTY
Dementia
Delirium
Incontinence
Mobility problems
Pressure ulcers
Senility
Functional dependence
Anxiety and depression
Figure 4. Percentage over 65 CIS in Scotland with frailty diagnosis associated
Figure 2. Patient admissions to Scottish hospitals from
01 April 2014 to 31 March 2015
508,505
over 65 year olds
76,023
with a geriatric syndrome