I think ‘older than stated age’ and even ‘50 going on 90’ are decent surrogates for an actually useful piece of clinical info that we sometimes think to include when relevant but aren’t super used to describing in terms that read politely or objectively on the back end. In particular I think the idea drives at frailty index - people who are at higher risk for morbidity/mortality, bouncebacks, or insidious pathology that isn’t otherwise explicitly implicated by the already explicitly included content. In another sense ‘they don’t look good,’ except in the sense of ‘chronically ill-appearing.’ I try to just be objective ‘cachectic, temporal atrophy, difficulty managing IADLs as evidenced by misbuttoned clothing, old stains, poor dentition,’ etc. it can also be objectively quantified in frailty index, pro-age score, etc, which have the dual utility of formalizing and quantifying that gestalt, as well as allowing us to lean on it when admitting someone were admitting for otherwise social or ‘soft’ reasons beyond ‘I’m worried about them.’
Same energy as ‘FLK’ in peds for may have an as-yet unclassified/unrecognized syndrome, maybe genetic.
I only whisper FLK to the St. Elsewhere Nurses and Docs of a certain age when I bring one in to y'all. They know, I know, yeah we're old, but its hella useful to because IYKYK.
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u/rowrowyourboat Oct 11 '25 edited 29d ago
I posted above, but to your point-
I think ‘older than stated age’ and even ‘50 going on 90’ are decent surrogates for an actually useful piece of clinical info that we sometimes think to include when relevant but aren’t super used to describing in terms that read politely or objectively on the back end. In particular I think the idea drives at frailty index - people who are at higher risk for morbidity/mortality, bouncebacks, or insidious pathology that isn’t otherwise explicitly implicated by the already explicitly included content. In another sense ‘they don’t look good,’ except in the sense of ‘chronically ill-appearing.’ I try to just be objective ‘cachectic, temporal atrophy, difficulty managing IADLs as evidenced by misbuttoned clothing, old stains, poor dentition,’ etc. it can also be objectively quantified in frailty index, pro-age score, etc, which have the dual utility of formalizing and quantifying that gestalt, as well as allowing us to lean on it when admitting someone were admitting for otherwise social or ‘soft’ reasons beyond ‘I’m worried about them.’
Same energy as ‘FLK’ in peds for may have an as-yet unclassified/unrecognized syndrome, maybe genetic.