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Aging Clin Exp Res. 2019 Dec;31(12):1839-1842. doi: 10.1007/s40520-018-1105-8. Epub 2019 Jan 8.

Does the identification of seniors at risk (ISAR) score effectively select geriatric patients on emergency admission?

Author information

1
Department of Geriatrics, Hospital Meyriez and Tafers, HFR, University Fribourg, Fribourg, Switzerland. wolfram.weinrebe@h-fr.ch.
2
Ageing Clinical Research, Department of Internal Medicine II, University Hospital Cologne, Cologne, North Rhine Westphalia, Germany.
3
Clinic for Orthopedics and Trauma Surgery, Coblenz, Rhineland-Palatibate, Germany.
4
Department of Geriatrics, St. Marien Hospital, Cologne, North Rhine Westphalia, Germany.
5
Department of Geriatrics/Rehabilitation, Clinic Wartenberg, Wartenberg, Bavaria, Germany.
6
Outpatient Clinic for Occupational Therapy, Bad Friedrichshall, Baden-Württemberg, Germany.
7
Institute for Biostatistics, Berlin, Germany.
8
Department of Geriatrics, Hospital Meyriez and Tafers, HFR, University Fribourg, Fribourg, Switzerland.
9
Department of Geriatrics, Helios Clinic Schwelm, University Witten-Herdecke, Witten, North Rhine Westphalia, Germany.

Abstract

The number of older patients admitted to emergency departments (ED) increases continuously. The Identification of Seniors at Risk (ISAR) score is currently recommended to screen patients in German ED, but its appropriateness is being criticized. ISAR scores and clinical characteristics from 98 emergency admissions (EA), 80 from acute geriatrics (AG) and 89 from a geriatric rehabilitation (GR) unit were compared retrospectively. No significant differences were found between groups, being the ISAR score positive in 87.7% of EA, 94.9% of AG and 94.4% of GR cases. None of positively identified geriatric patients in the EA was transferred to the geriatric ward of competence. EA patients showed significantly higher number of functional impairments (p = 0.001) and higher BI score (p < 0.0001) compared to AG and GR groups. A higher ISAR score threshold and additional functional information might be needed to better select patients in need of prompt treatment by a geriatric team.

KEYWORDS:

Emergency admission; Geriatric patients; ISAR; Selection for acute geriatric treatment

PMID:
30623316
DOI:
10.1007/s40520-018-1105-8
[Indexed for MEDLINE]

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