P-667: Clinical Frailty Index in practice: how do patients' self-assessment of frailty compare with clinical assessment in the acute setting? A pilot study

摘要

Introduction: The Rockford Clinical Frailty Score (CFS) is used to identify patients that may benefit from a comprehensive geriatric assessment as well as informing discharge planning and predict mortality. We compared participants' self-rated frailty according to the CFS against clinician assessment made at hospital admission. Methods: Elderly care patients on the Emergency Floor of Worthing Hospital who met the following criteria were invited to participate: documented CFS, no known dementia or delirium diagnosis and Abbreviated Mental Test Score > 7They were shown a visual Rockwood score with descriptors and asked to estimate their own frailty. This was then compared with clinician assessment from the admission paperwork. Results: 44% of 25 participants rated their frailty differently to the clinician. Of these participants 72% rated themselves as less frail than clinician assessment. 12% of participants rated themselves significantly less frail than the clinician (Indicated by a difference of > 1 point on the CFS). The maximum discrepancy was 4 points on the CFS. To further assess these results prior to the conference we will conduct a formal review of participants multidisciplinary admission notes and discharge outcomes. Key conclusions: There appears to be a discrepancy in CFS scoring between patient and clinician warranting further investigation. Differences in perception of frailty between patient and clinician may lead to conflict within care decisions and discharge planning. It may well be that by taking these divergent opinions into account we could improve the planning and delivery of care both in hospital and once discharged.