Title of article :
SCREENING FOR FRAILTY IN ELDERLY EMERGENCY DEPARTMENT
PATIENTS BY USING THE IDENTIFICATION OF SENIORS AT RISK (ISAR)
Author/Authors :
F. Salvi1، نويسنده ,
Issue Information :
روزنامه با شماره پیاپی سال 2012
Abstract :
Frail older adults are at an increased risk for adverse outcomes after an emergency
Department (eD) visit. comprehensive geriatric assessment (cGa) has been proposed to screen for frailty in the
eD, but it is difficult to carry out. We tested whether a cGa-based approach using the identification of Seniors
at risk (iSar) screening tool was associated with the brief deficit accumulation index (Dai) of frailty. Design:
prospective observational study. Setting: two urban eDs in italy. Participants: a cohort of 200 elderly (≥65
years) eD patients. Measurements: identifiers, triage, clinical and social data along with the administration of
iSar. cGa was performed using: charlson index, Short portable Mental Status Questionnaire and Katz’s aDl.
Follow-up data at 30 and 180 days included: mortality, eD revisit, hospital admission, and functional decline.
Frailty was defined according to a brief Dai. logistic regression evaluated the consistency of the frailty
definition; roc curves evaluated iSar ability in identifying frailty. Results: Frailty was present in 117 (58.5%)
subjects and predicted eD revisit and frequent eD return, hospitalization and 6-month mortality. iSar had an
auc of 0.92 (95%ci 0.88-0.96, p<0.0001) in identifying frail elders in the eD and using a cut-off of 2 showed
94% sensitivity and 63% specificity. Conclusion: iSar is a useful screening tool for frailty and identifies elderly
patients at risk of adverse outcomes after an eD visit. iSar can also be used to select high-risk patients more
likely to benefit from a geriatric approach or intervention, independently of admission or discharge.
Keywords :
Emergency department , outcome , Geriatric Assessment , Frailty , screening
Journal title :
The journal of nutrition, health & aging
Journal title :
The journal of nutrition, health & aging