Old and New Geriatric Screening Tools in a Belgian Emergency Department: A Diagnostic Accuracy Study

Heeren, Pieter and Devriendt, Els and Wellens, Nathalie I. H. and Deschodt, Mieke and Flamaing, Johan and Sabbe, Marc and Milisen, Koen. (2020) Old and New Geriatric Screening Tools in a Belgian Emergency Department: A Diagnostic Accuracy Study. Journal of the American Geriatrics Society, 68 (7). pp. 1454-1461.

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Official URL: https://edoc.unibas.ch/76821/

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To compare the diagnostic accuracy of the Identification of Seniors at Risk, the Flemish version of Triage Risk Screening Tool, and the interRAI Emergency Department Screener for predicting prolonged emergency department (ED) length of stay, hospitalization (following index ED stay), and unplanned ED readmission at 30 and 90 days among older (aged ≥70 years) community-dwelling adults admitted to the ED.; Single-center, prospective, observation study.; ED with embedded observation unit in University Hospitals Leuven (Belgium).; A total of 794 patients (median age = 80 years; 55% female) were included.; Study nurses collected data using semistructured interviews and patient record review during ED admission. Outcome data were collected with patient record review.; Hospitalization (following index ED stay) and unplanned ED readmission at 30 and 90 days occurred in 67% (527/787) of patients and in 12.2% (93/761) and 22.1% (168/761) of patients, respectively. For all outcomes at cutoff 2, the three screening tools had moderate to high sensitivity (range = 0.71-0.90) combined with (very) low specificity (range = 0.14-0.32) and low accuracy (range = 0.21-0.67). At all cutoffs, likelihood ratios and interval likelihood ratios had no or small impact (range = 0.46-3.95; zero was not included) on the posttest probability of the outcomes. For all outcomes, area under the receiver operating characteristics curve varied in the range of 0.49 to 0.62.; Diagnostic characteristics of all screening tools were comparable. None of the tools accurately predicted the outcomes as a stand-alone index. Future studies should explore the clinical effectiveness and implementation aspects of ED-specific minimum geriatric assessment and intervention strategies.
Faculties and Departments:03 Faculty of Medicine > Departement Public Health > Institut für Pflegewissenschaft
UniBasel Contributors:Deschodt, Mieke
Item Type:Article, refereed
Article Subtype:Research Article
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:30 Dec 2020 09:20
Deposited On:30 Dec 2020 09:20

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