National Survey of Geriatricians to Define Functional Decline in Elderly People with Minor Trauma

  • Kasim Abdulaziz Department of Emergency Medicine, University of Ottawa
  • Jeffrey J. Perry University of Ottawa; Ottawa Hospital Research Institute
  • Monica Taljaard University of Ottawa; Ottawa Hospital Research Institute
  • Marcel Émond Université Laval; Unité de recherche en traumatologie-urgence-soins intensifs du Centre de recherche FRQ-S du CHA de Québec
  • Jacques S. Lee University of Toronto, Clinical Epidemiology Unit, Sunnybrook Health Sciences Center
  • Laura Wilding University of Ottawa
  • Marie-Josée Sirois Université Laval; Unité de recherche en traumatologie-urgence-soins intensifs du Centre de recherche FRQ-S du CHA de Québec
  • Jamie Brehaut University of Ottawa; Ottawa Hospital Research Institute
Keywords: activities of daily living (ADL), clinical decision rules, functional decline, geriatric assessment, Older Americans Resources and Services (OARS)

Abstract

Background

This study was designed to determine a clinically significant point drop in function to define functional decline and the required sensitivity for a clinical decision tool to identify elderly patients at high risk of functional decline following a minor injury.

Methods

After a rigorous development process, a survey questionnaire was administered to a random sample of 178 geriatricians selected from those registered in a national medical directory. The surveys were distributed using a modified Dillman technique.

Results

We obtained a satisfactory response rate of 70.5%. Ninety percent of the geriatricians required a sensitivity of 90% or less for a clinical decision tool to identify injured seniors at high risk of functional decline 6 months post injury. Our results indicate that 90% of the respondents considered a drop in function of at least 2 points in activities of daily living (ADL) as clinically significant when considering all 14 ADL items. Considering only the 7 basic ADL items, 90% of physicians considered a 1 point drop as clinically significant.

Conclusions

A tool with a sensitivity of 90% to detect patients at risk of functional decline at 6 months post minor injury would meet or exceed the sensitivity required by 90% of geriatric specialists. These findings clearly define what is a clinically significant decline following a “minor injury.”

 

Author Biographies

Kasim Abdulaziz, Department of Emergency Medicine, University of Ottawa
Department of Epidemiology and Community Medicine; Clinical Epidemiology Program
Jeffrey J. Perry, University of Ottawa; Ottawa Hospital Research Institute
Department of Epidemiology and Community Medicine; Clinical Epidemiology Program; Department of Emergency Medicine
Monica Taljaard, University of Ottawa; Ottawa Hospital Research Institute
Department of Epidemiology and Community Medicine; Clinical Epidemiology Program;
Marcel Émond, Université Laval; Unité de recherche en traumatologie-urgence-soins intensifs du Centre de recherche FRQ-S du CHA de Québec
Department of Family and Emergency Medicine
Jacques S. Lee, University of Toronto, Clinical Epidemiology Unit, Sunnybrook Health Sciences Center
Department of Emergency Medicine
Laura Wilding, University of Ottawa
Department of Emergency Medicine
Marie-Josée Sirois, Université Laval; Unité de recherche en traumatologie-urgence-soins intensifs du Centre de recherche FRQ-S du CHA de Québec
Département de réadaptation
Jamie Brehaut, University of Ottawa; Ottawa Hospital Research Institute
Department of Epidemiology and Community Medicine; Clinical Epidemiology Program
Published
2015-12-21
How to Cite
Abdulaziz, K., Perry, J. J., Taljaard, M., Émond, M., Lee, J. S., Wilding, L., Sirois, M.-J., & Brehaut, J. (2015). National Survey of Geriatricians to Define Functional Decline in Elderly People with Minor Trauma. Canadian Geriatrics Journal, 19(1), 2-8. https://doi.org/10.5770/cgj.19.192
Section
Original Research