Clinical Frailty Score in Emergency Department

Introduction

• Speaker: Dr. Sunny Jockler, Emergency Medicine Registrar at Leicester Oil Infirmary ED
• Session: How to perform a clinical frailty (CF) score in ED
• Goal: Plan and tailor interventions for patients
• Series: Part of a series of teaching sessions over six months

Topics Covered

1. Introduction to Clinical Frailty Score
2. Application of CF Score to Patients
3. Approach to Frail Patients

Clinical Frailty Score (CF Score)

• Purpose: Directly correlates with adverse outcomes (higher CF score = higher morbidity and mortality)
• Important Note: Do not rely on pictures; refer to the descriptors
• Resource: QR code for the Clinical Frailty App to help score patients

Key Considerations

• Context is Key: Ask about patient capability from two weeks ago, not currently
• Differentiating between CFS 6 and 7:
  • CFS 6: Needs help with outdoor activities and some basic activities
  • CFS 7: Dependent on all forms of personal care (hygiene, toileting)

Mortality Rates

• CFS 6: ~6% mortality during hospital admission
• CFS 7: ~11% mortality during hospital admission

Step-by-Step Approach

1. Assess Frailty: Is the patient frail?
   • No: Focus on the current problem
   • Yes: Determine CFS using the app
2. Understand Patient Wishes: Determine patient preferences and special requests (e.g., treatment at home)
3. Decision Making: Involve family, next of kin, and care homes where possible
4. Goals of Care: Decide what is achievable for the patient (comfort vs. active interventions)

Key Messages

• Role of Clinicians: You can make a significant impact; communicate effectively with patients and families
• Team Approach: Always discuss cases with seniors and other specialties
• Continuous Learning: Embrace learning opportunities from these patients
• Appropriate Care: Sometimes less intervention is better, if that's what's right for the patient

Resources

• Further Learning: QR codes and links on slides for more information about frailty