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JFSF Vol 7, No 2, June 2022, p.95-100

doi: 10.22540/JFSF-07-095


Short Communication

Scoring the Clinical Frailty Scale in the Emergency Department: The Home FIRsT Experience

Owen Thorpe1, Elva McCabe1, Elena Marie Herrero1, William Ormiston Doyle1, Aoife Dillon2, Lucinda Edge3, Sinéad Flynn4, Anna Mullen2, Aisling Davis5, Aoife Molamphy5, Anna Kirwan5, Robert Briggs2,6, Amanda H. Lavan2,6, Darragh Shields7, Geraldine McMahon7, Arthur Hennessy7, Una Kennedy7, Paul Staunton7, Emer Kidney7, Sarah-Jane Yeung7, Deirdre Glynn7, Frances Horgan8, Conal Cunningham2,6, Roman Romero-Ortuno2,6,9

  1. School of Medicine, Trinity College Dublin, Ireland
  2. MedEL Directorate, St James’s Hospital, Dublin, Ireland
  3. Department of Physiotherapy, St James’s Hospital, Dublin, Ireland
  4. Department of Social Work, St James’s Hospital, Dublin, Ireland
  5. Department of Occupational Therapy, St James’s Hospital, Dublin, Ireland
  6. Discipline of Medical Gerontology, Trinity College Dublin, Ireland
  7. Emergency Department, St James’s Hospital, Dublin, Ireland
  8. School of Physiotherapy, Royal College of Surgeons in Ireland, Dublin, Ireland
  9. Global Brain Health Institute, Trinity College Dublin, Ireland

Keywords: Clinical Frailty Scale, Disability, Emergency Department, Geriatric Assessment, Mobility


We evaluated predictors of the Clinical Frailty Scale (CFS) scored by an interdisciplinary team (Home FIRsT) performing comprehensive geriatric assessment (CGA) in our Emergency Department (ED). This was a retrospective observational study (service evaluation) utilising ED-based CGA data routinely collected by Home FIRsT between January and October 2020. A linear regression model was computed to establish independent predictors of CFS. This was complemented by a classification and regression tree (CRT) to evaluate the main predictors. There were 799 Home FIRsT episodes, of which 740 were unique patients. The CFS was scored on 658 (89%) (median 4, range 1-8; mean age 81 years, 61% women). Independent predictors of higher CFS were older age (p<0.001), history of dementia (p<0.001), mobility (p≤0.007), disability (p<0.001), and higher acuity of illness (p=0.009). Disability and mobility were the main classifiers in the CRT. Results suggest appropriate CFS scoring informed by functional baseline.