Frailty Identification in Prehospital Care: A Scoping Review of the Literature

Abstract

The proportion of older adults is increasing worldwide. Frailty assessment in prehospital care was suggested to improve triage decisions and paramedics’ judgment. This study aimed to assess the scope and nature of available evidence around frailty identification in prehospital care. A systematic search of the literature was performed using MEDLINE, SCOPUS, CINHAL, and Web of Science to identify relevant articles published from January 2022 downwards. A list of indexed terms and their associated alternatives were pre-determined. Of the 71 identified and reviewed articles after removing duplicates, six articles were included in the review. Due to the heterogeneity of the included articles, the findings were described narratively. The findings of this review showed that the available evidence is limited and heterogenic. Two themes emerged from the findings of the included articles: 1) Paramedics’ Perceptions about Frailty Assessment in Prehospital Care and 2) Frailty Scores for Application in Prehospital Care. Paramedics recognised frailty assessment in pre-hospital care to be feasible and important. They highlighted the need for a simple and clear frailty score that could be used and mentioned to other healthcare professionals when handing over patients. Six frailty scores were reported to be used in prehospital care. The evidence around each frailty score is very limited. Overall, frailty assessment in prehospital care was shown to be important and feasible. Different frailty scores have been assessed for use in prehospital care. Further research investigating frailty identification in prehospital care is needed.

Keywords:

• aging consumers
• narrative analysis
• health and well-being
• paramedic*
• emergency
• older

Abbreviations

USA, United States of America; UK, United Kingdom; CFS, Clinical Frailty Scale; JBIv Joanna Briggs Institute; PRISMA-ScR, Preferred Reporting Items of Systematic Reviews and Meta-Analysis extension for Scoping Review; PICO, Population, Intervention, Comparison, and Outcomes; CP-CGA, Care Partner- Comprehensive Geriatric Assessment; CP-FI-CGA, Care Partner-derived Frailty Index based up on Comprehensive Geriatric Assessment; EFS, Edmonton Frail Scale; GFI, Groningen Frailty Index; TUG, Timed-Up and Go; 4-item PERIL, The 4-item Elders at Risk of Independence Loss; ISAR, The Identifying Seniors at Risk; CCDS, Computerized Clinical Decision Support; ED, Emergency Department.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The Authors declare that there is no conflicts of interest.

Additional information

Funding

This research is funded by King Abdullah International Medical Research Center. The role of this funding is to cover publication fees for open access.