A novel multidimensional geriatric screening tool in the ED: evaluation of feasibility and clinical relevance

Schoenenberger, Andreas; Bieri, Christoph; Özgüler, Sait Onur; Moser, André; Haberkern Schläpfer, Monika; Zimmermann, Heinz; Stuck, Andreas; Exadaktylos, Aristomenis (2014). A novel multidimensional geriatric screening tool in the ED: evaluation of feasibility and clinical relevance. American journal of emergency medicine, 32(6), pp. 623-628. W.B. Saunders 10.1016/j.ajem.2014.03.024

Text 1-s2.0-S0735675714001909-main.pdf - Published Version Restricted to registered users only Available under License Publisher holds Copyright. Download (312kB)

PURPOSES

Geriatric problems frequently go undetected in older patients in emergency departments (EDs), thus increasing their risk of adverse outcomes. We evaluated a novel emergency geriatric screening (EGS) tool designed to detect geriatric problems.

BASIC PROCEDURES

The EGS tool consisted of short validated instruments used to screen 4 domains (cognition, falls, mobility, and activities of daily living). Emergency geriatric screening was introduced for ED patients 75 years or older throughout a 4-month period. We analyzed the prevalence of abnormal EGS and whether EGS increased the number of EGS-related diagnoses in the ED during the screening, as compared with a preceding control period.

MAIN FINDINGS

Emergency geriatric screening was performed on 338 (42.5%) of 795 patients presenting during screening. Emergency geriatric screening was unfeasible in 175 patients (22.0%) because of life-threatening conditions and was not performed in 282 (35.5%) for logistical reasons. Emergency geriatric screening took less than 5 minutes to perform in most (85.8%) cases. Among screened patients, 285 (84.3%) had at least 1 abnormal EGS finding. In 270 of these patients, at least 1 abnormal EGS finding did not result in a diagnosis in the ED and was reported for further workup to subsequent care. During screening, 142 patients (42.0%) had at least 1 diagnosis listed within the 4 EGS domains, significantly more than the 29.3% in the control period (odds ratio 1.75; 95% confidence interval, 1.34-2.29; P<.001). Emergency geriatric screening predicted nursing home admission after the in-hospital stay (odds ratio for ≥3 vs <3 abnormal domains 12.13; 95% confidence interval, 2.79-52.72; P=.001).

PRINCIPAL CONCLUSIONS

The novel EGS is feasible, identifies previously undetected geriatric problems, and predicts determinants of subsequent care.

Interest & Impact

Downloads

0 since deposited on 01 Apr 2015
0 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item