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1550: THE EFFECT OF TRAUMA ADMISSION ON ADVERSE OUTCOMES AND PROGRESSION OF FRAILTY

INTRODUCTION/HYPOTHESIS: Frailty is recognized as a predictor of complications and poor outcomes in the geriatric patient population. Our aim was to study the prevalence of frailty and outcomes in patients following trauma admission to a critical care unit. We hypothesize the presence of admission frailty will be an independent predictor of higher mortality, increased length of stay, and will progress as a result of traumatic injuries post hospitalization within all age groups older than 24years old. METHODS: A prospective observational study was performed over a 3-month period on trauma patients in a trauma critical care unit. An admission frailty and at 6 weeks post-discharge frailty was determine using the 5-item FRAIL Scale. The study was approved by the Institutional Review Board Ethics Committee. All comparisons were performed at a level of significance of p ≤ 0.05. RESULTS: Of the 110 patients admitted to the Trauma ICU from January to March 2021, 25% were considered frail vs. 20% pre-frail vs. 55% non-frail. Mean age of frailty was 70 years old, the youngest age being 48 years old. Pre-frail patients with a mean age of 58 years old, a minimum age of 31years old. Comparing frail vs. non-frail patients', the frail patients had a higher mortality rate (57.1 vs 42.86% p- 0.16);Covid positivity (80 vs 20%, p- 0.03);ETOH (75 vs 25%, p-0.08);sepsis diagnosis (100% vs 0 p-0.09). No statistical significance in ICU LOS (p-0.16) and injury severity score (p-0.43). Statistical significance was achieved between the groups for HTN (p-< 0.0001) and DM (p-0.03). At 6-week post discharge frailty assessment of 67 patients demonstrated statistical significance between admission and post discharge frailty (p-< 0.0001). 25% of the admitted non-frail patients progress to frail state on post-discharge evaluation. 21% of the admitted non-frail patients progress to a pre-frail state. 19% percent of the admitted pre-frail patients progress to a frail state. CONCLUSIONS: Although statistical significance was not achieved in mortality and LOS, both groups trended in the direction towards significance, calling for a larger randomized control trial. We did, however, demonstrate that trauma admission increases frailty scores in all groups. This trend was most revealing in the non-geriatric group.