Accumulated frailty characteristics predict XXXX institutionalization in the geriatric @entity1 .

@entity1 @entity73 @entity734 @entity86
BACKGROUND: Frailty is a state of increased vulnerability to health-related stressors and can be measured by summing the number of frailty characteristics present in an individual. Discharge institutionalization (rather than discharge to home) represents disease burden and functional @entity734 after hospitalization. Our aim was to determine the relationship between frailty and need for @entity86 institutionalization. STUDY DESIGN: Subjects >=  65 years undergoing major elective operations requiring postoperative ICU admission were enrolled. Discharge institutionalization was defined as need for institutionalized care at hospital discharge. Fourteen preoperative frailty characteristics were measured in 6 domains: comorbidity burden, function, nutrition, @entity73 , and extrinsic frailty. RESULTS: A total of 223 subjects (mean age 73    6 years) were studied. Discharge institutionalization occurred in 30% (n = 66). Frailty characteristics related to need for @entity86 institutionalization included: older age, Charlson index >=  3, hematocrit <35%, any functional @entity734 , up-and-go >=  15 seconds, albumin <3.4 mg/dL, Mini-Cog score  <= 3, and having fallen within 6 months (p < 0.0001 for all comparisons). Multivariate logistic regression retained prolonged timed up-and-go (p < 0.0001) and any functional @entity734 (p < 0.0001) as the variables most closely related to need for discharge institutionalization. An increased number of frailty characteristics present in any one subject resulted in increased rate of discharge institutionalization. CONCLUSIONS: Nearly 1 in 3 geriatric @entity1 required discharge to an institutional care facility after major surgery. The frailty characteristics of prolonged up-and-go and any functional @entity734 were most closely related to the need for discharge institutionalization. Accumulation of a higher number of frailty characteristics in any one geriatric @entity1 increased their risk of discharge institutionalization.
