What’s in a Name? Understanding Failure to Thrive and Frailty in the Emergency Department

This is the authors' abstract. We don't add key points for this paper.

Up to 20% of older adults present to the Emergency Department (ED) with nonspecific symptoms such as generalized weakness or fatigue. Failure to thrive and frailty are two terms that are often used interchangeably for nonspecific complaints and aging. Despite their often-interchangeable use, the terms are very different. Failure to thrive is a poorly defined term that, when used, is often a disservice to patients, as it may minimize the perception of an acute medical condition. By contrast, frailty is a well-defined, measurable, geriatric syndrome that can help assess patients' function, ability for safe independent living, and risks in undergoing invasive procedures. It is important for the emergency clinician to avoid the umbrella term of "failure to thrive" and instead remain vigilant for symptoms such as confusion, fatigue, and poor appetite to be atypical presentations of acute emergencies such as pneumonia, heart failure, and intra-abdominal emergencies. It is similarly important to recognize frailty as an independent risk factor for complications of surgery or invasive procedures, and be aware of the growing literature around frailty and how its identification may be helpful in the ED.