Prevalence of Frailty in European Emergency Departments (FEED): an international flash mob study
European Taskforce on Geriatric Emergency Medicine (ETGEM) collaborators, Tim Coats, Simon Conroy, Bas de Groot, Pieter Heeren, Stephen Lim, Jacinta A. Lucke, Simon P. Mooijaart, Christian H. Nickel, Rose Penfold, Katrin Singler, James David van Oppen, Effie Polyzogopoulou, Arina Kruis, Rosa McNamara, Bas de Groot, Santiago Castejon-Hernandez, Òscar Miró, Mehmet Akif Karamercan, Zerrin Defne Dündar, James David van Oppen, Martina Pavletić, Pavla Libicherová, Frédéric Balen, Axel Benhamed, Xavier Dubucs, Romain Hernu, Sai͏̈d Laribi, Katrin Singler, O. Fraidakis, Varvara Fyntanidou, Effie Polyzogopoulou, Szabolcs Gaál, Anna Björg Jónsdóttir, Mary Elizabeth Kelly-Friel, Claire A. McAteer, Lisa Diandra Sibthorpe, Aoife Synnott, Maria Beatrice Zazzara, Sophie M. Coffeng, Bas de Groot, Jacinta A. Lucke, Rosalinde A. L. Smits, Santiago Castejon-Hernandez, Lluís Llauger, Sira Aguiló Mir, Miguel Sánchez Ortiz, Eduardo Enrique Padilla, Santiago Cotobal Rodeles, Wojciech Rojewski-Rojas, Davide Fadini, Natalie Sabrina Jegerlehner, Christian H. Nickel, Sara Rezzonico, Enrico Carlo Zucconi, Sümeyye Çakmak, Hüseyin Avni DEMİR, Zerrin Defne Dündar, Ramazan Güven, Mehmet Akif Karamercan, Ozgur Sogut, İsmail Tayfur, James Alexander Adams, Janice Bernardo, Leanne Brown, Joel Burton, Matthew Butler, Renate Isabelle Claassen, F H Compton, Jamie G. Cooper, Ruth Heyes, Sally Ko, Calvin John Lightbody, Jane Masoli, Stephen Thomas Gerard McKenzie, David Mawhinney, Nicola Jayne Moultrie, Angeline Price, Rajendra Raman, L Rothwell, R Shashikala, Erica Jane Smith, Vittoria Sorice, James David van Oppen, J. M. Wallace, Tom Young, Ana Benvin, Edita Breški, Alda Ćefo, Dijana Dumić, Rea Ferenac, Ivanka Jurica, Marinka Otočan, Petra Šverko Zinaić, Bénédicte Clement, Laurent Jacquin, B. Royer, Stefanie Irmgard Apfelbacher, Sofia Bezati, Sofia Gkarmiri
Abstract
INTRODUCTION: Current emergency care systems are not optimized to respond to multiple and complex problems associated with frailty. Services may require reconfiguration to effectively deliver comprehensive frailty care, yet its prevalence and variation are poorly understood. This study primarily determined the prevalence of frailty among older people attending emergency care. METHODS: This cross-sectional study used a flash mob approach to collect observational European emergency care data over a 24-h period (04 July 2023). Sites were identified through the European Task Force for Geriatric Emergency Medicine collaboration and social media. Data were collected for all individuals aged 65 + who attended emergency care, and for all adults aged 18 + at a subset of sites. Variables included demographics, Clinical Frailty Scale (CFS), vital signs, and disposition. European and national frailty prevalence was determined with proportions with each CFS level and with dichotomized CFS 5 + (mild or more severe frailty). RESULTS: Sixty-two sites in fourteen European countries recruited five thousand seven hundred eighty-five individuals. 40% of 3479 older people had at least mild frailty, with countries ranging from 26 to 51%. They had median age 77 (IQR, 13) years and 53% were female. Across 22 sites observing all adult attenders, older people living with frailty comprised 14%. CONCLUSION: 40% of older people using European emergency care had CFS 5 + . Frailty prevalence varied widely among European care systems. These differences likely reflected entrance selection and provide windows of opportunity for system configuration and workforce planning.