title: Frailty in acute cardiology: comparison of a quick clinical assessment against a validated frailty assessment tool.
abstract: BACKGROUND
  Increasingly frail patients are being to be referred for invasive cardiac interventions and cardiac surgery. We aimed to evaluate the utility of a quick clinical assessment of frailty against a validated frailty assessment tool in an acute cardiology setting.
  
  
  METHODS
  Forty-seven cardiology in-patients ≥70 years were recruited in this prospective study. All patients were first assessed by a senior cardiology registrar as either not-frail or frail. This was based on general observation and brief discussions. Following this, patients were administered the Reported Edmonton Frail Scale (REFS) questionnaire. After a registrar assessment, the foot-of-the bed frailty assessment was independently repeated by one or two consultant cardiologists.
  
  
  RESULTS
  None of the three clinicians showed satisfactory similarity to the REFS score. When the two consultants were compared with the registrar, and with each other, the Cohen's kappa was only above 0.7 for the comparison between Consultant 1 and the registrar. Consultant 1 and the registrar were also significantly more likely to disagree at higher REFS score with a mean REFS score of 8.8.
  
  
  CONCLUSIONS
  A quick foot-of-the-bed clinical assessment is not a reliable way to determine frailty.
authors: Cardiology Department, Christchurch Public Hospital, Canterbury District Health Board, Christchurch 8140, New Zealand. Electronic address: Timothy.Hii@cdhb.health.nz.
authors: Timothy B K
authors: TB
authors: Hii
authors: Cardiology Department, Christchurch Public Hospital, Canterbury District Health Board, Christchurch 8140, New Zealand.
authors: John G
authors: JG
authors: Lainchbury
authors: Cardiology Department, Christchurch Public Hospital, Canterbury District Health Board, Christchurch 8140, New Zealand.
authors: Paul G
authors: PG
authors: Bridgman
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000379:methods* / Q000401:mortality; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008297:Male; D009520:New Zealand; D009752:Nutritional Status; D015588:Observer Variation; D011446:Prospective Studies; D015203:Reproducibility of Results; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Acute care; Cardiac intervention; Cardiac surgery; Frailty assessment; Reported Edmonton Frail Scale