Allied Health and the Frail Patient in Hospital – A Prospective Cohort Study

James Bui; Vincent Ngian; Fiona Tran; Kirralee Scott; Ka Chi Ngai; Bin ONG

Just Accepted

This article has been peer reviewed and accepted for publication. It is in production and has not been edited, so may differ from the final published form.

Allied Health and the Frail Patient in Hospital – A Prospective Cohort Study

James Bui, Vincent Ngian, Fiona Tran, Kirralee Scott, Ka Chi Ngai, Bin ONG

Abstract

Objectives Frailty is associated with significant mortality and morbidity in hospitalised patients. We describe physiotherapy and occupational therapy practices in hospitalised frail patients and examine the role of early intervention. Methods We performed a prospective, observational cohort study in a medical assessment unit in a tertiary care hospital. Patients with COVID-19 infection were excluded. Frailty was measured by the Clinical Frailty Scale (CFS). Early allied health intervention was defined as involvement within 48 hours of admission. Demographic data, clinical diagnoses, time spent with physiotherapy and occupational therapy, CFS, hospital length of stay and outcomes were recorded and analysed. Results 356 patients were categorised into non-frail (CFS score <5) and frail (CFS score ≥5) groups. The prevalence of frailty was 68% (n=241). Physiotherapy (77.2%) and occupational therapy (75.5%) reviews were more frequent in frail patients than in non-frail patients. Frail patients who had allied health involvement within 48 hours of admission had a significant reduction in their hospital length of stay (mean reduction of 7.3 days, 95% CI: 0.53, 14, p=0.035) and a 2.44% reduction in the relative risk of developing pressure injuries (95% CI: 1.31, 4.53). There was no statistically significant differences in outcomes with allied health intervention for non-frail patients and patients who require residential aged care facility (RACF) level care. Conclusions Allied health have a major role in the management of frailty. Early allied health intervention was associated with a reduced hospital length of stay as well as a reduced incidence of pressure injury in frail patients.

AH24280 Accepted 06 November 2024