SP 2.04 Surgical Discharge or Medical Rescue? Clinical Frailty Predicts Prolonged Length of Stay and Readmission in Head Injury Patients

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ID: 324014
2026
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Abstract
Abstract Aims To assess the association between the Clinical Frailty Scale (CFS) and Length of Stay (LOS) in surgical head injury admissions. To determine whether early Comprehensive Geriatric Assessment (CGA), in line with BGS guidance, may reduce prolonged admission and readmission. Methods 78 consecutive patients admitted with head injury were stratified by CFS. Management was compared against British Geriatrics Society (BGS) "Fit for Frailty" standards, which advocate for CGA in patients with a CFS 5 or above. Results Data demonstrated a significant linear correlation between higher CFS and increased LOS. Patients with a CFS 5 or above experienced the most prolonged admissions, often driven by complex social requirements (increased packages of care) and medical comorbidities (e.g., hypotension/falls) rather than surgical intervention. Despite high frailty prevalence, the absence of formal CGA or medical-led retrieval correlated with a 21% (16/78) 30-day readmission rate in this cohort. Conclusion We propose that all surgical head injury patients with CFS > 5 undergo automatic "Medical-Geriatric" review or CGA upon admission. Whilst adopting a medically led "Surgical Rescue" model to reduce length of stay, prevent avoidable admissions and reduce risks of complications.
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Authors Sharmilaa Lagunathan, Sobitha Ahillan, Jennifer Ikegbunam
Journal the british journal of surgery
Year 2026
DOI
10.1093/bjs/znag087.023
URL
https://doi.org/10.1093/bjs/znag087.023
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