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) | Request a copy

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