Evaluation of the Hospital Pathway for Frail Elderly Patients Hospitalised for Pathologies Leading to Medical Decompensation

NCT ID: NCT06873256

Last Updated: 2025-11-20

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

310 participants

Study Classification

OBSERVATIONAL

Study Start Date

2025-02-28

Study Completion Date

2025-07-24

Brief Summary

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People aged over 75 account for 25% of emergency department visits in the Provence Alpes Côte d'Azur region. Depending on the facility, around 50% of these patients are discharged home without being hospitalised. Yet the scientific literature highlights the frequent deterioration in the physical and mental state of the elderly during a visit to the emergency department: discomfort on the stretcher, waiting, loneliness and disorientation are the causes, and therefore increase co-morbidity. Very few studies have been carried out to date to compare the impact on frailty risk factors of direct admission to hospital versus admission via emergency service for a frail elderly population. Studies are usually based on a population aged over 75 as the sole criterion, which no longer corresponds to the definition of a frail elderly person. What's more, there are major challenges in coordinating hospital and outpatient care to optimise resources.

The aim is to assess whether the creation of new care pathways, requiring considerable human and financial resources, will improve the care of frail elderly people. In order to assess the benefits of the systems set up at the hospital this study will compare the outcome of frail elderly people (≥ 75 years old with a geriatric score ≥ 8) hospitalised for medical decompensation pathologies according to their mode of admission, the management of their dependency and their accessibility to the attending physician, whether in individual accommodation or in an Residential Establishment for Dependent Elderly People.

This is a regional multicentre, observational, prospective and retrospective study looking at the future of frail elderly people hospitalised at the hospital during 2024/2025 (from 01/09/2024 to 01/03/2025).

The study will be conducted retrospectively, including patients hospitalised since 1st September 2024, and prospectively, including patients over time until the end of the inclusion period (01/03/2025). Patients will be followed for 90 days after hospitalisation, i.e. data will be collected until 01/06/2025.

Justification of the public interest

This research could make it possible to identify new protective factors against deterioration in the frail elderly, other than direct admission to a hospital ward, which would require fewer human and material resources, such as an Mobile Geriatric Team or a stay in a Short-Term Hospitalization Unit.

If direct admissions lead to fewer patients being admitted back to hospital, this could encourage existing medical and surgical specialties outside geriatrics and support geriatric assessment.

Lastly, this research would make it possible to draw up an inventory of the frailty of the elderly in the Toulon conurbation, in order to optimise the screening of frail elderly people in conjunction with the territorial care coordination west var region.

Data collection begins as soon as the frail elderly person is hospitalised and continues for up to 90 days after the start of hospitalisation (retrospectively and prospectively).

Detailed Description

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Conditions

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Frail Elderly People Hospitalized

Study Design

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Observational Model Type

COHORT

Study Time Perspective

OTHER

Study Groups

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Frail patients hospitalized for medical decompensation

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Patient aged ≥ 75 years;
* Patient cared for at the Intercommunal Hospital Center of Toulon-La Seyne sur Mer (Sainte Musse and Georges Sand hospitals) between 01/09/2024 and 01/03/2025 and presenting a geriatric score ≥ 8 (score defined by multidisciplinary work);
* Patient requiring hospitalisation for medical decompensation.

Exclusion Criteria

* Patient with acute pathologies requiring admission to the intensive care unit;
* Patient whose care is in the field of traumatology in isolation;
* Patient's refusal to take part in the research.
Minimum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Centre Hospitalier Intercommunal de Toulon La Seyne sur Mer

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Marc FOURNIER, MD

Role: STUDY_DIRECTOR

Centre Hospitalier Intercommunal Toulon- La Seyne sur mer

Locations

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Centre Hospitalier Intercommunal Toulon-La Seyne sur Mer

Toulon, Var, France

Site Status

Countries

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France

Related Links

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https://dumas.ccsd.cnrs.fr/dumas-03643709

The predictive validity of frailty status for hospitalization and mortality. In: The predictive validity of the state of frailty for hospitalization and mortality. Toulouse: The 2016 Gerontological Year; 2016. p. 49 49.Brun M. C3S Coordination Support Sc

https://sante.gouv.fr/IMG/pdf/icope_cahier_des_charges_220322.pdf

ICOPE - A program to prevent addiction \[Internet\]. 2023 \[cited 2024 Sep 22\].

https://www.drees.solidarites-sante.gouv.fr/publications/etudes-et-resultats/les-personnes-agees-aux-urgences-une-sante-plus-fragile

Elderly people in the emergency room: a more fragile health requiring longer care: Studies and results 2017; N°1008 Electronic ISSN 1146-9129.

https://www.drees.solidarites-sante.gouv.fr/publications-communique-de-presse/etudes-et-resultats/240711_ER_UrgencesHospitalieres2023

Hospital emergencies in 2023: what organizations for patient care? Studies and results 2024 N°1305; Electronic ISSN 1146-9129.

Other Identifiers

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2024-CHITS-011

Identifier Type: -

Identifier Source: org_study_id

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