{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T13:58:34Z","timestamp":1791467914776,"version":"4.3.4"},"reference-count":78,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T00:00:00Z","timestamp":1770163200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Frailty is a multidomain reduction in physiologic reserve that impacts recovery and can contribute to poor outcomes following trauma beyond what chronological age, comorbidities, or injury severity predicts. In geriatric trauma patients, a large proportion are frail or prefrail on initial encounter in the emergency department, and because there are opportunities for actionable management plans, major trauma guidelines endorse systematic screening integrated into coordinated geriatric trauma care. We reviewed the literature and identified practical instruments used in the acute trauma setting for risk stratification. Additionally, we highlight the feasibility of using these instruments, as some can be completed via patient report, proxy input, or chart review when cognition, language, or caregiver availability limits history-taking. Implementation efforts succeed when shared mental models are leveraged and screening is embedded in the electronic health record system, linked to order sets and trigger-based pathways that offer downstream goal-directed care management, such as early mobility, delirium prevention, nutrition, medication review, and comprehensive geriatric assessment. Additionally, we highlight the importance of initiating early goals-of-care discussions and coordinating care with palliative care services. Resource-limited systems can preserve the same architecture by using nurse-led or allied staff-led screening, tele-geriatric consultation, and virtual interdisciplinary huddles. Lastly, we expand upon opportunities for longitudinal post-discharge follow-up. We describe how targeted initiatives translate research into practice, improve outcomes, and support longitudinal reassessment through in-person and telehealth follow-up visits.<\/jats:p>","DOI":"10.3390\/jpm16020089","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T10:02:57Z","timestamp":1770199377000},"page":"89","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Frailty Screening in the Emergency Department Enables Personalized Multidisciplinary Care for Geriatric Trauma Patients"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4610-2574","authenticated-orcid":false,"given":"Oluwafemi P.","family":"Owodunni","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, University of New Mexico Hospital, Albuquerque, NM 87131, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Norii","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of New Mexico Hospital, Albuquerque, NM 87131, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8511-9291","authenticated-orcid":false,"given":"Sarah A.","family":"Moore","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of New Mexico Hospital, Albuquerque, NM 87131, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina L.","family":"Parks Bent","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of New Mexico Hospital, Albuquerque, NM 87131, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-Li","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of New Mexico Hospital, Albuquerque, NM 87131, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cameron S.","family":"Crandall","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of New Mexico Hospital, Albuquerque, NM 87131, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1503\/cmaj.050051","article-title":"A global clinical measure of fitness and frailty in elderly people","volume":"173","author":"Rockwood","year":"2005","journal-title":"CMAJ"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1016\/S0140-6736(12)62167-9","article-title":"Frailty in elderly people","volume":"381","author":"Clegg","year":"2013","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/j.jamcollsurg.2020.11.026","article-title":"Preoperative Frailty Assessment, Operative Severity Score, and Early Postoperative Loss of Independence in Surgical Patients Age 65 Years or Older","volume":"232","author":"Owodunni","year":"2021","journal-title":"J. Am. Coll. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e226","DOI":"10.1097\/SLA.0000000000005720","article-title":"Domains of Frailty Predict Loss of Independence in Older Adults After Noncardiac Surgery","volume":"278","author":"Goeddel","year":"2023","journal-title":"Ann. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1056\/NEJMra2301292","article-title":"Frailty in Older Adults","volume":"391","author":"Kim","year":"2024","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1097\/TA.0000000000003817","article-title":"Prospective validation and application of the Trauma-Specific Frailty Index: Results of an American Association for the Surgery of Trauma multi-institutional observational trial","volume":"94","author":"Joseph","year":"2023","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1482","DOI":"10.1213\/ANE.0000000000004687","article-title":"The Association of Frailty With Adverse Outcomes After Multisystem Trauma: A Systematic Review and Meta-analysis","volume":"130","author":"Poulton","year":"2020","journal-title":"Anesth. Analg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"112514","DOI":"10.1016\/j.injury.2025.112514","article-title":"A prospective multi-site cohort study on the prevalence of frailty in patients aged over 70 years presenting after serious injury and implications for outcomes","volume":"56","author":"Joseph","year":"2025","journal-title":"Injury"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Adeyemi, O., Grudzen, C., DiMaggio, C., Wittman, I., Velez-Rosborough, A., Arcila-Mesa, M., Cuthel, A., Poracky, H., Meyman, P., and Chodosh, J. (2025). Pre-injury frailty and clinical care trajectory of older adults with trauma injuries: A retrospective cohort analysis of A large level I US trauma center. PLoS ONE, 20.","DOI":"10.1371\/journal.pone.0317305"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"afad073","DOI":"10.1093\/ageing\/afad073","article-title":"Does frailty status predict outcome in major trauma in older people? A systematic review and meta-analysis","volume":"52","author":"Alqarni","year":"2023","journal-title":"Age Ageing"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1097\/TA.0000000000002583","article-title":"The impact of frailty on posttraumatic outcomes in older trauma patients: A systematic review and meta-analysis","volume":"88","author":"Zhao","year":"2020","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e001395","DOI":"10.1136\/tsaco-2024-001395","article-title":"Geriatric trauma triage: Optimizing systems for older adults\u2014A publication of the American Association for the Surgery of Trauma Geriatric Trauma Committee","volume":"9","author":"Egodage","year":"2024","journal-title":"Trauma Surg. Acute Care Open"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"904","DOI":"10.1097\/TA.0000000000004751","article-title":"The road less recovered: Examining the effect of trauma on frailty trajectories in older patients","volume":"99","author":"Falon","year":"2025","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1097\/TA.0000000000001329","article-title":"Redefining the association between old age and poor outcomes after trauma: The impact of frailty syndrome","volume":"82","author":"Joseph","year":"2017","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/j.jamcollsurg.2019.12.021","article-title":"Loss of Independence in Older Patients after Operation for Colorectal Cancer","volume":"230","author":"Gearhart","year":"2020","journal-title":"J. Am. Coll. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Legros, V., Seube-Remy, P.A., Floch, T., Chauchard, C., Leclercq-Rouget, M., Prevot-Minella, P.-A., Duvivier, A., Flamant, L., and Kanagaratnam, L. (2024). Frailty and 6-month trajectory of elderly trauma patients over the age of 65 years admitted to intensive care unit for severe trauma: Experience of a level 1 trauma center. BMC Geriatr., 24.","DOI":"10.1186\/s12877-024-05350-1"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1150","DOI":"10.1097\/TA.0000000000001250","article-title":"The impact of frailty on failure-to-rescue in geriatric trauma patients: A prospective study","volume":"81","author":"Joseph","year":"2016","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"104344","DOI":"10.1016\/j.archger.2021.104344","article-title":"Impacts of frailty on health care costs among community-dwelling older adults: A meta-analysis of cohort studies","volume":"94","author":"Chi","year":"2021","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Rivera-Hernandez, M., Kumar, A., Chou, L.N., Keeney, T., Ferdows, N., Karmarkar, A., Markides, K.S., and Ottenbacher, K. (2022). Healthcare utilization and costs among high-need and frail Mexican American Medicare beneficiaries. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0262079"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e1254","DOI":"10.1097\/SLA.0000000000005567","article-title":"Early Outcomes Following Implementation of a Multispecialty Geriatric Surgery Pathway","volume":"277","author":"Ehrlich","year":"2023","journal-title":"Ann. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e726","DOI":"10.1097\/SLA.0000000000005902","article-title":"Implementation of a Multi-specialty Geriatric Surgery Pathway Reduces Inpatient Cost for Frail Patients","volume":"278","author":"Ehrlich","year":"2023","journal-title":"Ann. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1097\/TA.0000000000000677","article-title":"Motor vehicle collision\u2013related injuries in the elderly: An Eastern Association for the Surgery of Trauma evidence-based review of risk factors and prevention","volume":"79","author":"Crandall","year":"2015","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1097\/TA.0000000000000981","article-title":"Frailty in trauma: A systematic review of the surgical literature for clinical assessment tools","volume":"80","author":"McDonald","year":"2016","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_24","unstructured":"Mangram, A., Berdeja, J., Cocanour, C., Cooper, Z., George, J., Ho, V., and Joseph, B. (2025, December 14). The American College of Surgeons Trauma Quality Improvement Program (TQIP). ACS TQIP Best Practices Guidelines: Geriatric Trauma Management. ACS. Available online: https:\/\/www.facs.org\/quality-programs\/trauma\/quality\/best-practices-guidelines\/."},{"key":"ref_25","unstructured":"(2025, December 14). Age-Friendly Health Systems Recognition|Institute for Healthcare Improvement. Available online: https:\/\/www.ihi.org\/partner\/initiatives\/age-friendly-health-systems\/recognition."},{"key":"ref_26","unstructured":"(2025, December 21). CMS Approves New 2025 Age-Friendly Hospital Measure. The John A. Hartford Foundation. Available online: https:\/\/www.johnahartford.org\/resources\/view\/cms-passes-new-2025-age-friendly-hospital-measure."},{"key":"ref_27","unstructured":"ACS (2025, December 21). CMS Age Friendly Hospital Measure. Available online: https:\/\/www.facs.org\/quality-programs\/accreditation-and-verification\/geriatric-surgery-verification\/cms-age-friendly-hospital-measure\/."},{"key":"ref_28","unstructured":"The American College of Surgeons Trauma Quality Improvement Program (TQIP) (2025, December 21). ACS TQIP Palliative Care Best Practices Guidelines. The American College of Surgeons Trauma Quality Improvement Program (TQIP) Guidelines. Available online: https:\/\/www.facs.org\/media\/g3rfegcn\/palliative_guidelines.pdf."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1795","DOI":"10.1016\/j.injury.2019.07.026","article-title":"Timing and methods of frailty assessments in geriatric trauma patients: A systematic review","volume":"50","author":"Cubitt","year":"2019","journal-title":"Injury"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e066329","DOI":"10.1136\/bmjopen-2022-066329","article-title":"Configurations and outcomes of acute hospital care for frail and older patients with moderate to major trauma: A systematic review","volume":"13","author":"Halter","year":"2023","journal-title":"BMJ Open"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1097\/TA.0000000000003472","article-title":"The feasibility and reliability of frailty assessment tools applicable in acute in-hospital trauma patients: A systematic review","volume":"92","author":"Cords","year":"2022","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2453","DOI":"10.1089\/neu.2023.0008","article-title":"Role of Frailty Status in Prediction of Clinical Outcomes of Traumatic Spinal Injury: A Systematic Review and Meta-Analysis","volume":"40","author":"Rohollahi","year":"2023","journal-title":"J. Neurotrauma"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1089\/neu.2023.0176","article-title":"Prognostic Value of Frailty for Outcome Following Traumatic Brain Injury: A Systematic Review and Meta-Analysis","volume":"41","author":"Roohollahi","year":"2024","journal-title":"J. Neurotrauma"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1186\/s13017-023-00506-7","article-title":"Assessing and managing frailty in emergency laparotomy: A WSES position paper","volume":"18","author":"Tian","year":"2023","journal-title":"World J. Emerg. Surg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1093\/ageing\/afaa180","article-title":"The Clinical Frailty Scale predicts adverse outcome in older people admitted to a UK major trauma centre","volume":"50","author":"Rickard","year":"2021","journal-title":"Age Ageing"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.jamcollsurg.2017.11.005","article-title":"New 5-Factor Modified Frailty Index Using American College of Surgeons NSQIP Data","volume":"226","author":"Subramaniam","year":"2018","journal-title":"J. Am. Coll. Surg."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1016\/j.jamda.2017.07.005","article-title":"FRAIL Questionnaire Screening Tool and Short-Term Outcomes in Geriatric Fracture Patients","volume":"18","author":"Gleason","year":"2017","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"100383","DOI":"10.1016\/j.pcorm.2024.100383","article-title":"Validation of the self-reported Edmonton frail scale\u2014Acute care in patients \u2265 65 years undergoing surgery","volume":"35","author":"Owodunni","year":"2024","journal-title":"Perioper. Care Oper. Room Manag."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Sirisegaram, L., Owodunni, O.P., Ehrlich, A., Qin, C.X., Bettick, D., and Gearhart, S.L. (2023). Validation of the self-reported domains of the Edmonton Frail Scale in patients 65 years of age and older. BMC Geriatr., 23.","DOI":"10.1186\/s12877-022-03623-1"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1778","DOI":"10.1016\/j.spinee.2023.08.008","article-title":"A comprehensive analysis of the triad of frailty, aging, and obesity in spine surgery: The risk analysis index predicted 30\u2013day mortality with superior discrimination","volume":"23","author":"Owodunni","year":"2023","journal-title":"Spine J."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1038\/s41366-023-01423-0","article-title":"Multiplicative effect of frailty and obesity on postoperative mortality following spine surgery: A deep dive into the frailty, obesity, and Clavien-Dindo dynamic","volume":"48","author":"Owodunni","year":"2023","journal-title":"Int. J. Obes."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2070","DOI":"10.1111\/j.1532-5415.2009.02497.x","article-title":"The Vulnerable Elders-13 Survey Predicts 5-year Functional Decline and Mortality Outcomes Among Older Ambulatory Care Patients","volume":"57","author":"Min","year":"2009","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e2512689","DOI":"10.1001\/jamanetworkopen.2025.12689","article-title":"Risk Analysis Index for Estimation of 30-Day Postoperative Mortality in Hip Fractures","volume":"8","author":"Gupta","year":"2025","journal-title":"JAMA Netw. Open"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1097\/TA.0000000000000551","article-title":"Feasibility of screening for preinjury frailty in hospitalized injured older adults","volume":"78","author":"Maxwell","year":"2015","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1016\/j.jamcollsurg.2019.02.052","article-title":"Frailty Identification and Care Pathway: An Interdisciplinary Approach to Care for Older Trauma Patients","volume":"228","author":"Bryant","year":"2019","journal-title":"J. Am. Coll. Surg."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"e000677","DOI":"10.1136\/tsaco-2021-000677","article-title":"Making your geriatric and palliative programs a strength: TQIP guideline implementation and the VRC perspective","volume":"6","author":"Ho","year":"2021","journal-title":"Trauma Surg. Acute Care Open"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"afae013","DOI":"10.1093\/ageing\/afae013","article-title":"Core requirements of frailty screening in the emergency department: An international Delphi consensus study","volume":"53","author":"Moloney","year":"2024","journal-title":"Age Ageing"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"(2016). Developed by the American Geriatrics Society Ethnogeriatrics Committee. Achieving High-Quality Multicultural Geriatric Care. J. Am. Geriatr. Soc., 64, 255\u2013260.","DOI":"10.1111\/jgs.13924"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"e001450","DOI":"10.1136\/tsaco-2024-001450","article-title":"Trauma care disparities: Is equity the key? Output from SAFER-Trauma","volume":"10","author":"Robles","year":"2025","journal-title":"Trauma Surg. Acute Care Open"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"728","DOI":"10.14245\/ns.2346496.248","article-title":"The Fine Line Between Simplicity and Oversimplification: Comparing the Risk Analysis Index and 5-Factor Modified Frailty Index as Frailty Assessment Tools","volume":"20","author":"Owodunni","year":"2023","journal-title":"Neurospine"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1111\/jgs.15076","article-title":"The Age-Friendly Health System Imperative","volume":"66","author":"Fulmer","year":"2018","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"2404","DOI":"10.1111\/jgs.17916","article-title":"Geriatric surgical service interventions in older emergency general surgery patients: Preliminary results","volume":"70","author":"Hu","year":"2022","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1001\/jamasurg.2022.1556","article-title":"Association Between Implementation of a Geriatric Trauma Clinical Pathway and Changes in Rates of Delirium in Older Adults With Traumatic Injury","volume":"157","author":"Park","year":"2022","journal-title":"JAMA Surg."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1001\/jamainternmed.2015.8042","article-title":"Comprehensive Geriatric Assessment and Transitional Care in Acutely Hospitalized Patients: The Transitional Care Bridge Randomized Clinical Trial","volume":"176","author":"Buurman","year":"2016","journal-title":"JAMA Intern. Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1001\/jamasurg.2024.1043","article-title":"Collaborative Care for Injured Older Adults: The Trauma Medical Home Randomized Clinical Trial","volume":"159","author":"Zarzaur","year":"2024","journal-title":"JAMA Surg."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1111\/jgs.16959","article-title":"An Age-Friendly Health System","volume":"69","author":"Lundy","year":"2021","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"105816","DOI":"10.1016\/j.clineuro.2020.105816","article-title":"Frailty and spontaneous intracerebral hemorrhage: Does the modified frailty index predict mortality?","volume":"194","author":"Kim","year":"2020","journal-title":"Clin. Neurol. Neurosurg."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Pellen, N., Beurton-Couraud, L., Goff-Coquet, A.L., Trame\u00e7on, A., Gentric, A., and Le Reste, J.Y. (2025). Five reasons for the failure of frailty screening in primary care: Lessons from the experience with ICOPE monitor step 1. BMC Geriatr., 25.","DOI":"10.1186\/s12877-025-06789-6"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1016\/S0140-6736(19)31786-6","article-title":"Frailty: Implications for clinical practice and public health","volume":"394","author":"Hoogendijk","year":"2019","journal-title":"Lancet"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1001\/jamasurg.2022.4718","article-title":"Adherence to the TQIP Palliative Care Guidelines Among Patients With Serious Illness at a Level I Trauma Center in the US","volume":"157","author":"Pierce","year":"2022","journal-title":"JAMA Surg."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"American College of Emergency Physicians, American Geriatrics Society, Emergency Nurses Association, Society for Academic Emergency Medicine, and Geriatric Emergency Department Guidelines Task Force (2014). Geriatric Emergency Department Guidelines. Ann. Emerg. Med., 63, e7\u2013e25.","DOI":"10.1016\/j.annemergmed.2014.02.008"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/j.annemergmed.2021.06.013","article-title":"Reach and Adoption of a Geriatric Emergency Department Accreditation Program in the United States","volume":"79","author":"Kennedy","year":"2022","journal-title":"Ann. Emerg. Med."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"100247","DOI":"10.1016\/j.acepjo.2025.100247","article-title":"A Model for Developing Subspecialty Clinical Practice Guidelines: The Geriatric Emergency Department Guidelines 2.0","volume":"6","author":"Gunaga","year":"2025","journal-title":"J. Am. Coll. Emerg. Physicians Open"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"e038082","DOI":"10.1136\/bmjopen-2020-038082","article-title":"Frailty in major trauma study (FRAIL-T): A study protocol to determine the feasibility of nurse-led frailty assessment in elderly trauma and the impact on outcome in patients with major trauma","volume":"10","author":"Jarman","year":"2020","journal-title":"BMJ Open"},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Jarman, H., Crouch, R., Halter, M., Peck, G., and Cole, E. (2022). Provision of acute care pathways for older major trauma patients in the UK. BMC Geriatr., 22.","DOI":"10.1186\/s12877-022-03615-1"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1136\/emermed-2022-212982","article-title":"Silver Trauma Review Clinic: A novel model of care to manage non-operative injuries in older patients","volume":"40","author":"Smyth","year":"2023","journal-title":"Emerg. Med. J."},{"key":"ref_67","first-page":"CD013088","article-title":"Case management for integrated care of older people with frailty in community settings","volume":"2023","author":"Sadler","year":"2023","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1376","DOI":"10.1016\/S0140-6736(19)31785-4","article-title":"Management of frailty: Opportunities, challenges, and future directions","volume":"394","author":"Dent","year":"2019","journal-title":"Lancet"},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Sims-Gould, J., Elliott, J., Tong, C.E., Gigu\u00e8re, A., Mallinson, S., and Stolee, P. (2021). A national intervention to support frail older adults in primary care: A protocol for an adapted implementation framework. BMC Geriatr., 21.","DOI":"10.1186\/s12877-021-02395-4"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1647","DOI":"10.1111\/imj.70171","article-title":"Evaluation of interventions for trauma care in older adults: A consensus study","volume":"55","author":"Ferrah","year":"2025","journal-title":"Intern. Med. J."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"6692","DOI":"10.1080\/09638288.2021.1970258","article-title":"Factors influencing care and support for older adults with traumatic injury in Australia: A qualitative study","volume":"44","author":"Schwarzman","year":"2022","journal-title":"Disabil. Rehabil."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"e050892","DOI":"10.1136\/bmjopen-2021-050892","article-title":"Systematic review of 29 self-report instruments for assessing quality of life in older adults receiving aged care services","volume":"11","author":"Siette","year":"2021","journal-title":"BMJ Open"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"e894","DOI":"10.1161\/CIR.0000000000000483","article-title":"Prioritizing Functional Capacity as a Principal End Point for Therapies Oriented to Older Adults With Cardiovascular Disease","volume":"135","author":"Forman","year":"2017","journal-title":"Circulation"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1016\/0277-9536(93)90066-D","article-title":"Validity and reliability testing of the FAMCARE Scale: Measuring family satisfaction with advanced cancer care","volume":"36","author":"Kristjanson","year":"1993","journal-title":"Soc. Sci. Med."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"105803","DOI":"10.1016\/j.jamda.2025.105803","article-title":"Leveraging the Transitional Care Model Intervention to Identify and Mitigate Adverse Social Determinants of Health","volume":"26","author":"Osokpo","year":"2025","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1093\/geront\/20.6.649","article-title":"Relatives of the Impaired Elderly: Correlates of Feelings of Burden","volume":"20","author":"Zarit","year":"1980","journal-title":"Gerontologist"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"2422","DOI":"10.1111\/jgs.19545","article-title":"A Large Language Model Approach to Identifying Preoperative Frailty Among Older Adults From Clinical Notes","volume":"73","author":"Zhou","year":"2025","journal-title":"J. Am. Geriatr. 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