Comparative Analysis of Frailty Scales in Emergency Department: Highlighting the Strengths of the Triage Frailty and Comorbidity Tool.

IF 1.8 4区医学 Q2 EMERGENCY MEDICINE

Journal of Emergency Nursing Pub Date : 2024-11-05 DOI:10.1016/j.jen.2024.09.012

Arian Zaboli, Francesco Brigo, Gloria Brigiari, Magdalena Massar, Marta Ziller, Serena Sibilio, Gianni Turcato

{"title":"Comparative Analysis of Frailty Scales in Emergency Department: Highlighting the Strengths of the Triage Frailty and Comorbidity Tool.","authors":"Arian Zaboli, Francesco Brigo, Gloria Brigiari, Magdalena Massar, Marta Ziller, Serena Sibilio, Gianni Turcato","doi":"10.1016/j.jen.2024.09.012","DOIUrl":null,"url":null,"abstract":"Introduction: Currently, there is uncertainty about which frailty scale is most appropriate and valid for use in the emergency department. The objective of this study was to compare the most commonly used frailty scales in triage and evaluate their performance.Methods: This prospective, single-center observational study was conducted from June to December 2023. Data collection spanned 80 days, during which the triage nurse recorded frailty scales using the Clinical Frailty Scale, Identification of Seniors at Risk, Program of Research to Integrate the Service for the Maintenance of Autonomy 7 (PRISMA-7), and the Triage Frailty and Comorbidity tool. The Clinical Frailty Scale, Identification of Seniors at Risk, and PRISMA-7 were used for patients aged >65 years, whereas the Triage Frailty and Comorbidity tool was applied to all patients presenting to the emergency department. The scales were compared using the area under the receiver operating characteristic curve for 90-day mortality, 30-day mortality, and hospitalization.Results: A total of 1270 patients were enrolled during the study period. In comparing the receiver operating characteristic curves, the Triage Frailty and Comorbidity tool demonstrated a receiver operating characteristic curve of 0.894 (95% CI: 0.858-0.929), whereas the Clinical Frailty Scale had 0.826 (95% CI: 0.762-0.890), PRISMA-7 had 0.814 (95% CI: 0.751-0.876), and Identification of Seniors at Risk had 0.821 (95% CI: 0.759-0.882), with a comparison P value of 0.03. The Triage Frailty and Comorbidity tool also significantly outperformed the other scales for 90-day mortality, 30-day mortality, and hospitalization across the overall population. Considering only the population aged >65 years, it identifies frail patients equally well as the other tools.Discussion: The findings of this study suggest that the Triage Frailty and Comorbidity tool is a valid instrument for assessing frailty in the emergency department. Moreover, among the scales used, it is the only 1 that considers the entire adult population, not just those aged >65 years, making it more inclusive for a setting such as the emergency department.","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":" ","pages":""},"PeriodicalIF":1.8000,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Emergency Nursing","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jen.2024.09.012","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"EMERGENCY MEDICINE","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction: Currently, there is uncertainty about which frailty scale is most appropriate and valid for use in the emergency department. The objective of this study was to compare the most commonly used frailty scales in triage and evaluate their performance.

Methods: This prospective, single-center observational study was conducted from June to December 2023. Data collection spanned 80 days, during which the triage nurse recorded frailty scales using the Clinical Frailty Scale, Identification of Seniors at Risk, Program of Research to Integrate the Service for the Maintenance of Autonomy 7 (PRISMA-7), and the Triage Frailty and Comorbidity tool. The Clinical Frailty Scale, Identification of Seniors at Risk, and PRISMA-7 were used for patients aged >65 years, whereas the Triage Frailty and Comorbidity tool was applied to all patients presenting to the emergency department. The scales were compared using the area under the receiver operating characteristic curve for 90-day mortality, 30-day mortality, and hospitalization.

Results: A total of 1270 patients were enrolled during the study period. In comparing the receiver operating characteristic curves, the Triage Frailty and Comorbidity tool demonstrated a receiver operating characteristic curve of 0.894 (95% CI: 0.858-0.929), whereas the Clinical Frailty Scale had 0.826 (95% CI: 0.762-0.890), PRISMA-7 had 0.814 (95% CI: 0.751-0.876), and Identification of Seniors at Risk had 0.821 (95% CI: 0.759-0.882), with a comparison P value of 0.03. The Triage Frailty and Comorbidity tool also significantly outperformed the other scales for 90-day mortality, 30-day mortality, and hospitalization across the overall population. Considering only the population aged >65 years, it identifies frail patients equally well as the other tools.

Discussion: The findings of this study suggest that the Triage Frailty and Comorbidity tool is a valid instrument for assessing frailty in the emergency department. Moreover, among the scales used, it is the only 1 that considers the entire adult population, not just those aged >65 years, making it more inclusive for a setting such as the emergency department.

查看原文本刊更多论文

急诊科虚弱量表的比较分析：突出分诊虚弱和合并症工具的优势。

前言目前，在急诊科使用哪种虚弱量表最合适、最有效还存在不确定性。本研究旨在比较分诊中最常用的虚弱量表，并评估其性能：这项前瞻性单中心观察研究于 2023 年 6 月至 12 月进行。数据收集时间跨度为 80 天，在此期间，分诊护士使用临床虚弱量表、高危老年人识别、维护自主性服务整合研究计划 7（PRISMA-7）和分诊虚弱和合并症工具记录虚弱量表。临床虚弱量表、高危老年人识别和 PRISMA-7 适用于年龄大于 65 岁的患者，而分诊虚弱和合并症工具则适用于急诊科的所有患者。使用接收者操作特征曲线下面积对 90 天死亡率、30 天死亡率和住院率进行了比较：结果：在研究期间，共有 1270 名患者入组。在比较接收器操作特征曲线时，Triage Frailty and Comorbidity 工具的接收器操作特征曲线为 0.894（95% CI：0.858-0.929），而临床虚弱量表为 0.826（95% CI：0.762-0.890），PRISMA-7 为 0.814（95% CI：0.751-0.876），风险老年人识别为 0.821（95% CI：0.759-0.882），比较 P 值为 0.03。在总体人群的 90 天死亡率、30 天死亡率和住院率方面，分诊虚弱与合并症工具也明显优于其他量表。仅考虑年龄大于 65 岁的人群，该工具识别体弱患者的能力与其他工具相当：讨论：本研究的结果表明，分诊虚弱和合并症工具是评估急诊科虚弱状况的有效工具。此外，在所使用的量表中，它是唯一一个考虑到整个成年人群，而不仅仅是年龄大于 65 岁的人群的量表，这使得它在急诊科这样的环境中更具包容性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Emergency Nursing 医学-护理

CiteScore

3.10

自引率

11.80%

发文量

132

审稿时长

46 days

期刊介绍： The Journal of Emergency Nursing, the official journal of the Emergency Nurses Association (ENA), is committed to the dissemination of high quality, peer-reviewed manuscripts relevant to all areas of emergency nursing practice across the lifespan. Journal content includes clinical topics, integrative or systematic literature reviews, research, and practice improvement initiatives that provide emergency nurses globally with implications for translation of new knowledge into practice. The Journal also includes focused sections such as case studies, pharmacology/toxicology, injury prevention, trauma, triage, quality and safety, pediatrics and geriatrics. The Journal aims to mirror the goal of ENA to promote: community, governance and leadership, knowledge, quality and safety, and advocacy.