Identifying Frailty and Its Associated Factors Among Patients With Traumatic Brain Injury in Vietnam
Tung Hoang Tran, Hai Minh Vu, Tham Thi Nguyen, Carl Latkin, Laurent Boyer, Bastien Boussat, Pascal Auquier, Huyen Do, Cyrus S. H. HoABSTRACT
Background
Traumatic brain injury (TBI) is a leading cause of long‐term disability and mortality, particularly in low‐ and middle‐income countries (LMICs), where post‐discharge rehabilitation services are often limited. Frailty is a multidimensional construct encompassing physical, cognitive, psychological, and social vulnerability. After TBI, multidimensional frailty may overlap with disability, depressive symptoms, persistent neurological problems, and social vulnerability. However, little is known about Groningen Frailty Indicator (GFI)‐defined frailty among adults after hospital discharge for TBI in resource‐limited settings.
Methods
A cross‐sectional study was conducted among 212 adult patients discharged after TBI from Thai Binh General Hospital, Vietnam. Data were collected via structured telephone interviews during a study period extending from January to August 2020. Frailty was measured using the GFI and operationally defined as a score of ≥ 4. Multivariable logistic regression was used to examine factors associated with GFI‐defined frailty status.
Results
The prevalence of GFI‐defined frailty was 36.8%, despite the majority (93.9%) having mild TBI. In the adjusted logistic model, female sex was associated with lower odds of GFI‐defined frailty than male sex (aOR = 0.37; 95% CI: 0.15–0.87), and rural residence was associated with lower odds than urban residence (aOR = 0.24; 95% CI: 0.09–0.66). Current smoking (aOR = 2.80; 95% CI: 1.10–7.14), post‐injury sequelae (aOR = 2.39; 95% CI: 1.15–4.98), depressive symptoms (aOR = 3.24; 95% CI: 1.23–8.54), and friend‐group support (aOR = 1.58; 95% CI: 1.07–2.34) were associated with higher odds of GFI‐defined frailty. Overall, 33.0% of participants reported post‐injury sequelae, and 10.2% experienced catastrophic health expenditure. Friend‐group support was positively associated with frailty, suggesting that higher reported support from friends may reflect greater support needs among frail patients after discharge rather than a harmful effect of social support.
Conclusions
GFI‐defined frailty was common among reachable adults discharged after TBI from this single hospital. The identified relationships are cross‐sectional associations and may partly reflect overlap between frailty, functional limitation, psychological burden, and social‐support needs. Post‐discharge follow‐up should consider functional, psychological, social, occupational, and financial vulnerability in addition to neurological symptoms. Multicenter longitudinal studies incorporating pre‐injury status and rehabilitation exposure are needed to confirm these findings.