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Prevalence and severity of frailty amongst middle-aged and older adults conveyed to hospital by ambulance between 2010 and 2017 in Wales

Carole Fogg Orcid Logo, Tracey England Orcid Logo, Helen Daniels Orcid Logo, Bronagh Walsh Orcid Logo

Age and Ageing, Volume: 54, Issue: 5, Start page: afaf124

Swansea University Author: Helen Daniels Orcid Logo

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DOI (Published version): 10.1093/ageing/afaf124

Abstract

Background: Ambulance services are commonly used by older adults. The scope of services continues to adapt in response to more non–life-threatening calls, often due to the acute consequences of chronic illness. Frailty increases with increasing age, but it is not known how common or severe it is wit...

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Published in: Age and Ageing
ISSN: 0002-0729 1468-2834
Published: Oxford University Press (OUP) 2025
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URI: https://cronfa.swan.ac.uk/Record/cronfa69545
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spelling 2025-05-20T15:05:07.1714477 v2 69545 2025-05-20 Prevalence and severity of frailty amongst middle-aged and older adults conveyed to hospital by ambulance between 2010 and 2017 in Wales a054902cb884be2476d0f097f0016294 0000-0001-8899-0333 Helen Daniels Helen Daniels true false 2025-05-20 MEDS Background: Ambulance services are commonly used by older adults. The scope of services continues to adapt in response to more non–life-threatening calls, often due to the acute consequences of chronic illness. Frailty increases with increasing age, but it is not known how common or severe it is within patients conveyed to hospital by ambulance. Methods: Open cohort of people aged ≥50 living in Wales between 2010 and 2017. Routinely collected electronic data on ambulance attendances resulting in conveyance were linked to primary care data within the Secure Anonymised Information Linkage databank, and the electronic Frailty Index was calculated. The prevalence and severity of frailty according to patient and incident characteristics was described. Results: Of 1 264 094 individuals within the cohort, 23.8% were taken to hospital between 2010 and 2017, of which frailty was present in 84.3% of patients. There was an upward trend in the number of conveyances for patients with moderate and severe frailty across the years in all age groups. The distribution of frailty was similar across call categories, deprivation quintiles and out-of-hours incidents. Patients conveyed from residential homes had a higher level of frailty and comprised 8.7% of the total conveyances. Conclusions: The high prevalence of frailty within adults aged ≥50 with emergency conveyances suggests upskilling ambulance crews with frailty training to enhance their assessment and decision making may improve patient outcomes. The high proportion of conveyances from residential homes indicates scope for increasing integration of community services to provide more patient-centred care pathways. Journal Article Age and Ageing 54 5 afaf124 Oxford University Press (OUP) 0002-0729 1468-2834 frailty, prehospital care, conveyance, older people 19 5 2025 2025-05-19 10.1093/ageing/afaf124 Short report COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Another institution paid the OA fee This project is funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research (HSDR) programme, award HS&DR 16/116/43. 2025-05-20T15:05:07.1714477 2025-05-20T14:56:47.9596410 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Carole Fogg 0000-0002-3000-6185 1 Tracey England 0000-0001-7565-4189 2 Helen Daniels 0000-0001-8899-0333 3 Bronagh Walsh 0000-0003-1008-0545 4 69545__34322__dde17820320a48b8870c5443c98f48b4.pdf afaf124.pdf 2025-05-20T14:56:47.9595752 Output 483915 application/pdf Version of Record true © The Author(s) 2025. Published by Oxford University Press on behalf of the British Geriatrics Society. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (CC BY). true eng https://creativecommons.org/licenses/by/4.0/
title Prevalence and severity of frailty amongst middle-aged and older adults conveyed to hospital by ambulance between 2010 and 2017 in Wales
spellingShingle Prevalence and severity of frailty amongst middle-aged and older adults conveyed to hospital by ambulance between 2010 and 2017 in Wales
Helen Daniels
title_short Prevalence and severity of frailty amongst middle-aged and older adults conveyed to hospital by ambulance between 2010 and 2017 in Wales
title_full Prevalence and severity of frailty amongst middle-aged and older adults conveyed to hospital by ambulance between 2010 and 2017 in Wales
title_fullStr Prevalence and severity of frailty amongst middle-aged and older adults conveyed to hospital by ambulance between 2010 and 2017 in Wales
title_full_unstemmed Prevalence and severity of frailty amongst middle-aged and older adults conveyed to hospital by ambulance between 2010 and 2017 in Wales
title_sort Prevalence and severity of frailty amongst middle-aged and older adults conveyed to hospital by ambulance between 2010 and 2017 in Wales
author_id_str_mv a054902cb884be2476d0f097f0016294
author_id_fullname_str_mv a054902cb884be2476d0f097f0016294_***_Helen Daniels
author Helen Daniels
author2 Carole Fogg
Tracey England
Helen Daniels
Bronagh Walsh
format Journal article
container_title Age and Ageing
container_volume 54
container_issue 5
container_start_page afaf124
publishDate 2025
institution Swansea University
issn 0002-0729
1468-2834
doi_str_mv 10.1093/ageing/afaf124
publisher Oxford University Press (OUP)
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
document_store_str 1
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description Background: Ambulance services are commonly used by older adults. The scope of services continues to adapt in response to more non–life-threatening calls, often due to the acute consequences of chronic illness. Frailty increases with increasing age, but it is not known how common or severe it is within patients conveyed to hospital by ambulance. Methods: Open cohort of people aged ≥50 living in Wales between 2010 and 2017. Routinely collected electronic data on ambulance attendances resulting in conveyance were linked to primary care data within the Secure Anonymised Information Linkage databank, and the electronic Frailty Index was calculated. The prevalence and severity of frailty according to patient and incident characteristics was described. Results: Of 1 264 094 individuals within the cohort, 23.8% were taken to hospital between 2010 and 2017, of which frailty was present in 84.3% of patients. There was an upward trend in the number of conveyances for patients with moderate and severe frailty across the years in all age groups. The distribution of frailty was similar across call categories, deprivation quintiles and out-of-hours incidents. Patients conveyed from residential homes had a higher level of frailty and comprised 8.7% of the total conveyances. Conclusions: The high prevalence of frailty within adults aged ≥50 with emergency conveyances suggests upskilling ambulance crews with frailty training to enhance their assessment and decision making may improve patient outcomes. The high proportion of conveyances from residential homes indicates scope for increasing integration of community services to provide more patient-centred care pathways.
published_date 2025-05-19T05:27:14Z
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