Failure to Thrive and Frailty

With Katie Selman, MD

In this episode, Dr. Shenvi sits down with Dr. Katie Selman to discuss complex, frail older adults in the ED, and the problematic diagnosis of “failure to thrive” in older adults. Dr. Selman shares her expertise on how we, as emergency care providers can do better to understand and identify frailty in our older patients. She provides an overview of how to use the Clinical Frailty Scale in the ED (spoiler – there’s a handy app available!) to better predict the risks and outcomes for older adults in the ED. Dr. Selman is a Emergency Physician at the University of Maryland Shore Regional Medical Center. You can follow her on Twitter at @selmanmd.



  • Anderson RS, Hallen SAM. Generalized Weakness in the Geriatric Emergency Department Patient. Clinics in Geriatric Medicine. 2013;29(1):91–100.
  • Busby-Whitehead J, Fain MJ, Mohler MJ. Frailty. In: Reichel’s care of the elderly: clinical aspects of aging. 7th ed. Cambridge: Cambridge University Press; 2017. p. 97–106.
  • Clinical Frailty Scale [Internet]. Acute Frailty Network. NHS; 2021 [cited 2021Jul6]. Available from:
  • Kaeppeli T, Rueegg M, Dreher-Hummel T, Brabrand M, Kabell-Nissen S, Carpenter CR, et al. Validation of the Clinical Frailty Scale for Prediction of Thirty-Day Mortality in the Emergency Department. Annals of Emergency Medicine. 2020;76(3):291–300.
  • Kumeliauskas L, Fruetel K, Holroyd-Leduc JM. Evaluation of Older Adults Hospitalized with a Diagnosis of Failure to Thrive. Canadian Geriatrics Journal. 2013Jun3;16(2):49–53.
  • Tsui C, Kim K, Spencer M. The diagnosis “failure to thrive” and its impact on the care of hospitalized older adults: a matched case-control study. BMC Geriatrics. 2020;20(1).

Hosted by

Christina Shenvi


Dr. Christina Shenvi is an associate professor of Emergency Medicine at the University of North Carolina. She is fellowship-trained in Geriatric Emergency Medicine and is the founder of GEMCast. She is the director of the UNC Office of Academic Excellence, president of the Association of Professional Women in Medical Sciences, co-directs the ACEP/CORD Teaching Fellowship, is on the Annals of EM editorial board, is on the Geriatric ED Accreditation board of governors, and she teaches and writes about time management at

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